What is going on with my knee?

[InjuredandIrritated530]

I am a 22 year old female.

Starting 7 1/2 weeks ago, I have been having an immense amount of pain in my left knee, on both sides, in front of the patella (down toward the pre-patella part of my shin), over the top of my kneecap, as well as on the inside of the underside of my knee. My knee is completely unstable without a brace, and is constantly swollen.

The incident occurred while I was grappling with someone, and my knee was torqued in completely the wrong direction. However, I have had chronic knee problems before. At the beginning, I was experiencing severe pain, and could walk on it with the aid of crutches, it would grind and pop once and a while when I moved it. I, however, chose not to favor it because I know that if you guard it, problems will occur.

I have had 1 set of 4 x-rays done, and have had multiple different answers about what could be wrong. The initial radiologist said they saw a pre-patellar bursitis, and mentioned to me an abnormality with my bone, as well as some swelling. There were no broken bones and no fractures that they could see. In going to my primary care doctor, they disagreed and said that all they saw was the bursitis and nothing else, that the gap in my bone (abnormality on the xray attached) could be just a variation (you know, how everyone's bones aren't the same or whatever.) By this time, I had been stuck on crutches for 5 weeks.

I was told to get an MRI, which came back completely negative for any tears, or damage. Initially my doctor told me I didn't have to go see an orthopedic surgeon, and to start PT. He also urged me to start "weaning off " the crutches. As soon as I began PT and started trying to get off the crutches, my knee continued to deteriorate. After a couple weeks of PT, a week and a half ago I went to see an ortho surgeon who then told me I have a "kneecap subluxation" and that my pain might be because of a dislocation. He told me to continue PT and wean off the crutches, gave me a different knee brace, and sent me on my way, saying it should be better in a week or 2.

However, those two weeks have passed and my knee has continued to deteriorate, the swelling has gotten worse despite icing almost 10x a day, pain has jumped from a 7 1/2 on 1-10 to a constant 8 1/2-9, my knee buckles on me when I don't have the knee brace on, the popping and grinding sensation has now become constant, and I can't go long distances without the crutches. I am coming to the end of the PT sessions my insurance will cover free, and no improvement has occurred.

Please help me... Any thoughts? I'm getting irritated because I'm not finding the solution to the severity of the pain I'm in, and it's keeping me from my summer job.

[Heidi]

Hi
This is tricky to answer. Clearly there is a fairly major problem with your knee and I am surprised that nothing major was picked up on the X-ray or MRI. I don't think bursitis is the only problem as this shouldn't cause this degree of instability.
I think you should speak again to your orthopedic surgeon as if it was a patella subluxation it would be calming down by now.
Maybe further investigation is needed.