Ds (4) knee

[abigfuckinghohoho]

Posting in here for traffic to see if there's any nurses/doctors on here that might be able to help (seeing a paed with interests in rheumatology on Tuesday) ds knees have been swelling back and forth for a year or so he has clubfoot in his left side so calf is a bit slimmer on that side , we've seen this Rheuma before because ds orthopaedic consultant seen the swelling and she reckoned arthritis (runs in family) it's not hot to touch and doesn't stop him walking but he complains of pain , last paed diagnosed hypermobile joints and says nothing wrong with him - thoughts? Pic attached

Anybody?

My DD has hyper mobility in her knees and they don't swell at the sides like your ds'.
The previous paed seems a bit dismissive about hyper mobility there is a scale and some people suffer quite badly.
hypermobility.org/
Would be worth looking at to see if his current symptoms match.

I felt they were awful dismissive about it , it affects his hands too with gripping pencils etc we have ot in now but the doc doesn't seem to be taking it very seriously x

Has your gp referred you to a musculoskeletal clinic. My DD was seen by a specialist physio she wore insoles for a while and we were given a variety of exercises. We have currently been discharged from that clinic as she isn't symptomatic, but I know I can ask for a referral or contact them direct if that changes. From her referral I discovered that I have hypermobility in my wrists.
Some doctors are very dismissive of it, my friends DD has EDS and she had to fight for the diagnosis and ended up paying for private consultation with a leading expert.

Keep an eye on his skin as well. My daughter's knee did that and then she had purple spots on her skin which caused a meningococcal scare. Turned out to be Henoch Schonlein Purpura - an autoimmune response following a "nothing" sort of a cold that can be minor and go almost unnoticed or lethal if it affects the organs.

You're seeing a specialist next week. Not pretending doctors are perfect but likely to be more accurate than us.

Fwiw I have hypermobility (normal type of eds) and my fingers hurt at times holding pens (less now I don't do it so much now I'm not at school) cos they bend backwards.

My knees do swell on the middle side and they aren't even hypermobile but my ankles are and this puts strain on them unless I do enough exercise.

But see the specialist with as many photos as possible!

I'm a physio, although not a paeds physio. My first thought on seeing the photo is that correcting the fallen arches on both feet with insoles could really make a difference, as mentioned above. If you try yourself in bare feet - flatten your inner arch, and you'll see how your knee drops in towards the midline. This then changes the angle of pull of the quads muscles on the front of the thigh, so the kneecap doesn't 'track properly, causing problems there, and it also strains the ligament on the inside of the knee joint, causing pain there. It also becomes a bit of a vicious circle, because the changed angle of pull gives an advantage to the muscle that pull the kneecap out of line, so the quad on the inner thigh gets weaker, so there is even less of control of the kneecap and on it goes. He would need to be assessed for his insoles and they might need to be custom made to accommodate the left foot which may not be normally mobile. I say all this with the proviso that you can't really diagnose from a photo, but basically there is loads a physio could do with exercise too if they saw him, so if the consultant doesn't suggest it, please ask. Hope things get moving for him soon.

Whereabouts in the country are you?

Just another thought from not really physio mode - re the hypermobility of his hands and difficulty gripping. If he seems generally slightly 'floppy' and a bit unco-ordinated/clumsy, he might have dyspraxia, which OTs can help with. My son has it, but he doesn't have pain, so this is really just a thought prompted by the pen grip thing. My son's hand holding a normal pen looks really weird. Even if it isn't dyspraxia, OTs can advise on special pens and grips, cutlery etc to ease pain in his hands

I have hypermobile fingers and find typing much easier than using a pen.

You could get this mix pack of pencil grips to try which is best for him
www.amazon.co.uk/Mixed-Pencil-Grips-Handwriting-Aid/dp/B007IVC3O0/ref=sr_1_20?ie=UTF8&qid=1483695320&sr=8-20&keywords=pencil+grips

He needs to learn strategies to deal with push buttons, doors etc. I press lift buttons etc. with my knuckles or something I am holding as the top joints of my fingers bend backwards really easily. A physio told me to be careful about pushing heavy doors with my hand outstretched so I tend to push heavy doors by leaning on them. The OT should be able to help you with these sorts of things.

Interesting , he does have asd and his paed puts a lot of his clumsiness down to that , he already has specialist insoles he's had them for about 18 months -