Unexplained swelling in 5 year old's knee - Mothering Forums
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#1 of 8 Old 09-24-2009, 06:53 PM - Thread Starter
 
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My five year old son has woken up about 4 times in the last 6 months with pretty severe swelling in his right knee. He could not walk to school today so I took him in to urgent care. This is the 2nd time they've Xrayed it and found nothing other than swelling in the bursa around the front of his knee. He says it's very painful . The other times it has resolved with 2-3 days with ice and rest. I can't figure out what's happening to him!

This time they prescribed a sulfa antibiotic. I've never given him antibiotics and don't plan to start now... but I was tired of fighting with the doctor so I just went and picked it up.

Question... WHY on earth would an antibiotic be prescribed for this? Is there any benefit at all to giving him this medicine? If an antibiotic would be beneficial is there something natural I can give him in place of the sulfa drug?

Thanks in advance for any input.... I just want my little guy to be pain free again .

Val, Mama to Aidan (5 years) and Autumn (almost 2)
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#2 of 8 Old 09-25-2009, 01:26 PM - Thread Starter
 
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Bumping this...

Can anyone give me any input?

It was huge and horrible looking again this morning. DH is taking him back to urgent care .

Val, Mama to Aidan (5 years) and Autumn (almost 2)
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#3 of 8 Old 09-25-2009, 02:33 PM
 
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You need to have him see a rheumatologist. This doesn't sound like just a joint infection that ABx would help with. Have them check his white blood count to be sure it isn't an infection. They need to check his ESR and sed rate, not sure if that is the same thing. They can also check the rheumatoid factor level. But, negative levels don't always mean they don't have arthritis.

Now, ABx can help some types of arthritis. Did you know that kids can have arthritis too?

I would say that if this happens to one joint, and down the line, another joins, you are dealing with JIA/JRA. But, that is my NOT SO DR OPINION! Sometimes they can overdiagnose JRA. But, usually, if it has gone on for 6 wks, or more, it is time to consult with a rheumy.

Xrays aren't useful for arthritis until there is damage. Usually an ultrasound or MRI of the knee would be more helpful. They can do a steroid shot in the knee to keep this from happening more, and you may not even need regular arthritis meds, if it just stays with his knee.

I pray it isn't arthritis, and the ABx can cure this. But, not everyone knows that children have arthritis too. Kymberli
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#4 of 8 Old 09-25-2009, 02:45 PM - Thread Starter
 
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Originally Posted by fwlady View Post
You need to have him see a rheumatologist. This doesn't sound like just a joint infection that ABx would help with. Have them check his white blood count to be sure it isn't an infection. They need to check his ESR and sed rate, not sure if that is the same thing. They can also check the rheumatoid factor level. But, negative levels don't always mean they don't have arthritis.

Now, ABx can help some types of arthritis. Did you know that kids can have arthritis too?

I would say that if this happens to one joint, and down the line, another joins, you are dealing with JIA/JRA. But, that is my NOT SO DR OPINION! Sometimes they can overdiagnose JRA. But, usually, if it has gone on for 6 wks, or more, it is time to consult with a rheumy.

Xrays aren't useful for arthritis until there is damage. Usually an ultrasound or MRI of the knee would be more helpful. They can do a steroid shot in the knee to keep this from happening more, and you may not even need regular arthritis meds, if it just stays with his knee.

I pray it isn't arthritis, and the ABx can cure this. But, not everyone knows that children have arthritis too. Kymberli
I was worried about this. I have Lupus and arthritis but was told that since the kids inherited my DH's blood type, and not mine... their chances of inheriting my autoimmune disorder was low? I don't know how accurate that is. I am so concerned that they will have to deal with this too . I brought it up to the doctor and he kind of shrugged me off. My husband is at the hospital with him now and has been for about 2 hours so I hope they're doing an MRI. I hope hope hope it is not arthritis . It is just the one knee. He is SO active, running and jumping and being a kid. That would be awful for him. DH went with the objective of getting a consult to a specialist... so maybe it's time to take him to the Rheumy with me. I was trying to put that thought out of my mind as I was hoping against hope that it wasn't arthritis. If that is the case, wouldn't antibiotics make the problem worse? With my Lupus if I take ABX I flare horribly and am basically bedridden for weeks.

Val, Mama to Aidan (5 years) and Autumn (almost 2)
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#5 of 8 Old 09-25-2009, 05:15 PM
 
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Off the top of my head I'd be looking at RA and lyme disease FWIW.
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#6 of 8 Old 09-25-2009, 05:34 PM - Thread Starter
 
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Off the top of my head I'd be looking at RA and lyme disease FWIW.
They just got back from the doctors and they brought up Lymes Disease as well. Is that something they can cure or just treat? We're just waiting on blood test results now and a consult to a rheumy. Crossing my fingers that it's something easily treatable.

Thanks for the input!

Val, Mama to Aidan (5 years) and Autumn (almost 2)
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#7 of 8 Old 09-25-2009, 06:01 PM
 
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I am so glad you got the rheumy consult. Whether or not he has your DH's blood type, I really don't think is any consequence. I have done a lot of research on JRA because my DD has palindromic rheumatism. Which is JRA that comes and goes. It isn't as severe as JRA.

But, YES, having a direct relative with lupus gives him a bigger chance of having JRA. Sorry. I don't want to be the bearer of bad news. I found out that because I have psoriasis, all my children could be susceptible to an autoimmune disease. I didn't even know that. I also did not know that since it has been 10 yrs and I haven't developed RA, I am lucky, and probably won't. But, they go hand in hand.

We've had a long road trying to figure out what was going on with my DD. She will flare up for about 24-72 hrs from her back to both legs. She was also a tomboy and very active. I will share real quick what happened with her, as it is very unusual. Maybe there is something in your son's activities that will give you a clue.

My DD got bit by a dog Aug 8, 08, on her birthday, in her face. They stitched her, gave her a tetanus shot, but didn't put her on ABx. Since my baby was in the hospital, and my friend had her treated and was hysterical, neither of us thought about the ABx as a prophylactic. So, FF to mid Jan. She starts with a hip limp, which went to all of the joints on her right side and both legs were in pain. We went back and they tested her for strep. She was strep pos twice, and took 2 ABx, but NONE of my other 6 children got it from her, and they share a LOT. So, the dr and I believe she did get strep from the dog bite, and it went untreated because we just never knew.

So, as time went on, and it wasn't getting better, but worse, she was tested for Lyme, as was suggested. Well, the dr said he would test for ALL tick borne illnesses, although this was April and she hasn't been bitten since 2yo, and her back was being affected at this point. My theory was that she got Lyme from the dog bite. I asked if she could have Rocky Mountain Fever from the dog bite, and he laughed and said after this many months, if she had RMSF, we wouldn't be talking about it. (It is a very severe illness.)

Lo and behold, I find out 3 wks later that she tested pos for RMSF after they wanted to do the test again, per protocol. That came out pos too, but no one believed she had it as she was never hospitalized for it. But, she had a rash on her face TWICE that resembled this disease rash, not far from the bite. I even took a pic the 2nd time. It stayed for 2-3 days each.

So, I finally got the other ped to give her the correct ABx for RMSF. And, she gets BETTER!!!!!! After MONTHS of pain and having this come back over and over, she seems to be getting better. She does still flare, and she may for the rest of her life, but PR and other JRA can be activated by viruses and bacteria, which she has had a lot of besides from the dog bite, from my med fragile son catching everything under the sun and the other kids being sicker this year than ever before.

We're hoping that my DD's issues don't turn JRA, as it still can. She flares once every 3-4 wks, and I can't be sure that she didn't flare this last time from the stress of having 2 siblings in the hospital at the same time. But, it was about her time too.

Ibuprofen is good. Aleve can be better. My DD is allergic to Aleve. I hope for a quick cure or a quick diagnosis for your son. PM me anytime. I am not an expert, but I do know of some links if it is JRA, and the frustration of how long it can take to figure things out. My DD is still officially undiagnosed. But, we are getting a 2nd opinion at another rheumy's on Oct 7th. The first rheumy tried to say she was making it up or having "sympathy pains" because her brother is med fragile. NOT this child!! So, hopefully we can get some real answers there. Kymberli
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#8 of 8 Old 09-25-2009, 07:18 PM
 
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They just got back from the doctors and they brought up Lymes Disease as well. Is that something they can cure or just treat? We're just waiting on blood test results now and a consult to a rheumy. Crossing my fingers that it's something easily treatable.

Thanks for the input!
My son is currently dealing with Lyme -- his manifested first as Bell's Palsy (facial paralysis) with additional weakness/issues on the right side of his body. It was very, very scary.

With the neuro issues and the possibility of his having Lyme meningitis (he'd had a splitting headache much of the previous week), he currently has a PICC line for daily IV antibiotics for the next month.

You will get very different pictures of Lyme from infectious disease MDs versus random Internet searches. I suspect the truth lies someplace in between, but I personally lean closer to the infectious disease MD. Lyme is treatable -- more so if it is caught early. It can do permanent nerve damage if left untreated. Most people with Lyme eventually recover on their own, but since the consequences of *not* recovering are not good, it is generally treated with aggressive levels of antibiotics.

I think its very good that someone mentioned Lyme and is following up on that. The tests are not 100%, either -- they test for antibodies rather than the disease itself, and there are a bunch of reasons you might get a false negative or a false positive (though if you get a positive, you are reacting to *something* -- it might just be some other disease than Lyme).

For us -- DS began showing improvement within hours of his first dose of abx. The paralysis is retreating, his hearing on that side is back to normal, his hand and shoulder have full range of movement again. And it's clear that Lyme had him fatigued and feeling "under the weather" for several weeks before the Big Crisis that led to the diagnosis, because his energy has come back with a vengeance.

savithny, 42 year old moderate mom to DS Primo (age 12) and DD Secunda (age 9).

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