Q: I have pain in my both the knees. Pain is not in the same position of the knee but varies in and around knees. My orthopaedic doctor suggested to take an x-ray and ESR test. The ESR test first was 22. Then the third day after that test doctor asked me to repeat that test and I did that simultaneously in 2 different labs. In one lab it showed only 10 and the other lab it showed 22(22 is of the same lab where I did it for the first time). I could not understand why the difference is and which is correct. What are the normal values. The test was done in fasting. Doctor says x-rays reveal very minor wear and tear in both the knees (starting stage). But is that possible in my age (31 years) wear and tear of knees can occur?

A:There are many causes of pain in the knee. However, one thing is certain that you do NOT have any systemic internal serious disease causing your knee pain as your ESR is less than 28 mm (1st hour). According to the American College of Rheumatology ESR less than 28 is normal. Normal ESR means that you do NOT have a systemic internal disease of any serious nature. This leads us to a MECHANICAL/STRUCTURAL cause of the knee pain. The cause of this has to be found out by those specializing in the mechanical/structural derangements in the knee.