Arthritis or Soft Tissue Tear? How Can I Know? By Anonymous

Hello: I am 41 years old and weigh 250 pounds. I recently went to a sports medicine doctor, who told me I have severe OA and would simply become more crippled over time. Action included 4 steps - increase the arch in a new pair of orthotics for my feet, lose weight, physical therapy and Vioxx. Unfortunately, I was not there for the arthritis! I have had severe pain on top of the usual knee pain. The severe pain started in July, with rolling soft tissue at the right front of my knee cap. Occassionally the rolling would displace and pinge upon my knee cap.

Occassionally, I could bend my knee and get it back in place. This went on for 23 months until what felt like a tear occurred. The symptoms come on from standing or walking for 5-10 minutes. The result is severe pain in the front inside of my knee. It is not in the joint it os on the surface of the lower leg bone. Typically standing/walking drives the knee straight, out of pain. I walk stiff-legged until I can sit. Sitting is very painful and bending the knee is the same. After sitting a bit, i can walk again only the pain will increase with each episode and the ability to stand is shortened. Instead of happening 1-2 times per week, it happens all of the time! I went to a second doctor, and his belief is that it is OA 1st - soft tissue 2nd.

He gave me a cortisone shot - believing that if the pain came back it is OA and there is no need to do an MRI! I have now started to take Vicadin to stand the pain of standing and working. Work requires little walking - but I see my lifestyle as degrading quickly with the intro of pain pills - 3/day. The cortisone did help for 4 - 5 weeks. Pain is intense - I cannot tell if the Estim machine from therapy causes it, excessive heat application or OA.

My question is how do I protect my interest? I am in such pain - I cannot see a reason for taking a conservative approach when it comes to using an MRI as a diagnostic toll. What approach should I take with the doctors? What medical options and rights do I have?