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What is the cause of my knee pain?

Dr Anand Malaviya
Head of the Department of Medicine and Chief of Clinical Immunology and Rheumatology Services,
All-India Institute of Medical Sciences, New Delhi Consultant Rheumatologist, 'A&R Clinic'
Visiting Sr. Consultant, Rheumatologist, ISIC Superspeciality Hospital, New Delhi.

Q: I am a 26 years old female and suffer from knee pain. My ASO titre was found to be 400 and RA factor negative, but positive in dilution. My DNF and ANF tests were found to be negative. I was prescribed to have regular calcium supplements (Shelcal 500) for a period of time. But as soon as I stopped the medicine my problems relapsed again. What should I do?

A:The description provided by you about your knee pain in rather sketchy but appears to be what we call structural-mechanical pain. The ONLY blood test that was required has not been done namely ESR. However, I take it that it is probably normal. With these limitations, my likely diagnosis is mal-tracking of patella a common problem among young ladies for knee pains. This needs to be carefully evaluated by a specialist in knee joints or an experienced RHEUMATOLOGIST with expertise in knee joints.