Hello,

I'm sorry I can't get this note to be shorter... I have been going to a
Rheumatology doctor since 1-1/2 year with no real diagnose of my
chronic pain and swelling of my left knee.  My doctor says I have
reactive arthritis but she thinks something else is going on too.
The history of my "bones" condition is vast.  I was born with "club
feet" on both of my feet.  I had several major surgeries during my
youth and wore othopedic shoes until the age of 14.  I had an incident
back in 1996 (age 31) and was diagnosed by a 2nd doctor (2nd
opinion...)  with 3 internal fractures on 2 bones on my right foot & 3
ligaments torn three months after the incident.  It went downhill from
then.  In 1998, I had my right foot  (RF) ankle fused, in 1999 I had my
RF subtalar joint fused.  In 2001, I had both ankle & subtalar joints
fused on my left foot (the doctor found unclear fluid in my ankle and
had to re-operate 3 weeks later after flushing the ankle and putting in
antibiotic beads - no lab test came back positive for anything - no
fungus found).  I have to wear rocker bottom shoes everyday to ease my
walk.  My left knee started to hurt 1 -1/2 year ago when I bent down to
pick up something; I didn't think anything of it until it started
swelling up and the pain became greater.  I had an MRI+x-rays within 6
months of treatment - I ended up with a partial ACL torn and patella
shifting to the left (my patella on the right knee also shifts to the
right but not as much as the left).  I had 5 aspirations done
(drainage) of the fluid in my knee.  The only abnormal lab test is the
white cells count that was up to 32,000 as of 2 months ago.  I had
another aspiration today and I have to wait until tomorrow for the
total count of white cells (doctor is guessing between 35,000 or 40).
The fluid was tested numerous times, including for Lyme disease and
infection which all came back negative.  I take sulfasalazine &
naproxen everyday: this has been a relief for pain, but eventually I
swell up again and have to get it aspirated.  I tried physical therapy
for 6 weeks + at home, it was OK then started swelling up again, thus
my recent visit to the doctor.  She thinks if I go thru arthroscopic
surgery, it will come back again.  She wants to start me on biologic
response modifiers (BRMs) such as "etanercept" (Enbrel) and another
medication to choose from (Methotrexate, Leflunomide or
Hydroxychloroquine) which I am not really crazy about.  I have an
appointment with an orthopedic doctor in mid-May; she asked him to
evaluate the possibility of a biopsy of the synovium and/or offer other
options.  I am frustrated with the fact that there is no certain
diagnose or cure.  Any ideas anyone?