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What is the cause for knee pain?

Q: One of my friend is in China. He has send me mail regarding pain in his knee. Can you please help, because due to language problem, he cannot consult doctor in China. His mail is as follows: I have little bit pain in my knee from last 3 months, I don't know why this pain has taken place in my knee, I never fell down, there was nothing that hit my knee; no accident but pain does not go away from my leg. I have been massaging my knee and sometimes I put spray. Now the pain is less but not cured. Here there are no good dispensaries or good doctors. There is also a problem in communicating. My work involves standing, 6 hours continuously. I have started exercising to keep fit here. What should I do? Please ask the doctor to suggest soon. The pain has become much less and swelling is also less but today also little swelling is there.

A:It is extremely difficult to figure out from your friends narrative what exactly he has. He is not even given his age. He has mentioned about pain and swelling. Both these can happen in degenerative arthritis that occurs with normal aging and it could also happen in younger patients with arthritis. But, normally arthritis affects multiple joints. Rarely, it could happen in a single joint also. In the absence of any other information it is not possible for me to distinguish what your friend has. I would recommend the following: Ask your friend to get: 1. An Erythrocyte sedimentation ratio (ESR) of blood sample. 2. An X-ray of the knee standing antero-posterior and lateral 3. Rheumatoid factor - blood sample 4. Serum Uric Acid - blood sample These are simple tests and should be available in any lab. Details of his age and any further information along with results of the above cam help to decide the further course of management.

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