I have been lame for the last few weeks due to severe pain in my left knee. I went to the A&E and the doctor wasn’t sure, but he diagnosed Baker’s cyst, even though there was no swelling. Is this the correct diagnosis?
Very often the pain and swelling in the knee are caused by Baker’s cyst. Small growth usually develops as a result of injury or is associated with arthritis. Patients often say that their knee feels tight or uncomfortable after walking or other exercise. If the cyst ruptures, you will probably feel sudden pain and hear a “crack”. The knee may also look very red, swollen and hot.
But there are other, more serious diagnoses that can be mistaken for Baker’s cyst – such as blood clots – so it’s important for doctors to rule these out. GPs can refer patients for an ultrasound scan, which should help solve the problem.
Today’s reader has a knee problem and wonders if their pain may be due to a cyst
Other, less serious things can also mimic Baker’s cyst. If patients experience a sudden attack of pain after rapid movements, such as during sports, this may be what we call foot tennis. This is a rupture of the calf after a large or impactful step.
Ultrasound can also help diagnose this. Other possible problems may be tears or sprains in the knee itself.
The knee is a very complex joint with ligaments, tendons and shock absorbers called menisci. Sudden movements on an already diseased knee can cause damage to some of these elements.
Most of these conditions are treated with “conservative treatment” – rest, ice packs and painkillers.
A full evaluation with a physiotherapist can also help.
In some areas, you can make an appointment with a physiotherapist without a referral from your GP. It is worth calling the surgery to see if this is possible.
I was recently told that I had a bowel problem called proctitis. I read a lot of articles about Crohn’s disease and IBS, but never about it. Are there any new treatments that can be offered?
Proctitis is certainly less common than the other conditions you mention. The problem that causes inflammation of the tissue is different from the others, as it affects only the rectum, the lowest part of the intestine.
More from Dr. Ellie Cannon for The Mail on Sunday …
Patients realize that they have a problem when they feel a constant need to go to the toilet, see blood and suffer severe pain.
Some have diarrhea and have a constant feeling that their bowels are not empty, even when they are.
Doctors usually refer patients for a colonoscopy – a tube with a camera at the end is passed through the anus – to detect inflammation low in the gut.
Proctitis is usually part of another condition such as colitis or Crohn’s disease. But it can also be a condition on its own, caused by food poisoning, antibiotics or radiation therapy.
The treatment offered to patients will depend on the underlying cause. Doctors usually use anti-inflammatory drugs as steroids – in tablet form or as enemas.
If the trigger is thought to be an infection – such as bacteria in food – antibiotics or antiviral drugs may be helpful. In more severe cases, doctors may prescribe drugs that suppress the immune system, as the body’s response to a “fighter” can worsen the inflammation.
Powerful anti-inflammatory drugs such as infliximab are now available for some with very bad symptoms.
Changing your diet to reduce the risk of diarrhea can also relieve symptoms. This includes avoiding caffeine, high-fiber foods such as legumes and possibly lactose – the sugar found in milk is a natural laxative.
I suffer from asthma and take medication. Last September I was diagnosed with pseudomonas and I have been breathing much worse since then. I took and stopped taking antibiotics, but they didn’t seem to work. I was referred to a clinic, but was told there was a long wait for an hour. Do you have any advice?
For people with healthy lungs, pseudomonas – a type of bacteria we can breathe – does not cause problems. But for those with lung diseases, such as severe asthma, this can be very unpleasant.
Pseudomonas bugs are found in soil and water and can also cause urinary tract infections and open wounds.
The bacterium is known to be difficult to clean – it does not respond to commonly used antibiotics such as penicillin. Instead, doctors use a different type called ciprofloxacin, which is often given at an unusually high dose, twice a day.
For people with healthy lungs, pseudomonas – a type of bacteria we can breathe – does not cause problems. But for those with lung diseases, such as severe asthma, this can be very unpleasant
For some, even a long course of this treatment does not kill the bugs. In these cases, doctors may try different doses of antibiotics or deliver them by inhaler.
Patients may not have to wait long to see a counselor. The GP can contact the local Infectious Diseases Team, whose members can advise them on how to treat you. In the same way, the GP can ask the hospital’s breathing team if there are any suggestions.
In this way, in theory, you could start taking medication before you even visit a specialist.
There are also respiratory health teams in the UK, many of which can come home. You may be eligible for help depending on your age and the severity of the problem.
If your symptoms are not limited to infection, your problems may mean that your asthma is getting worse – and there are a number of treatments that can help.
How your pills can make hot flashes even worse
Did you suffer more than you expected from the heat? It may be caused by your medicine.
Do you have a question for Dr. Ellie?
Email DrEllie@mailonsunday.co.uk or email Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr. Ellie can only respond in a general context and cannot respond to individual cases or give personal answers. If you have health problems, always consult your doctor.
Last week on Twitter, I saw a post from someone about common antidepressants called SSRIs, who wanted to remind colleagues that pills can make them susceptible to heat stroke.
This was news to me, but a small investigation revealed reports of such reactions.
It is much more common to remain vulnerable to sunburn – this will usually be stated in the patient’s information on side effects such as “photosensitivity”.
There are common medicines you need to know about, such as doxycycline and tetracycline – antibiotics used for acne – as well as the heart medicine amiodarone and the anti-inflammatory naproxen.
This does not mean that you are allergic to the sun, you are just hypersensitive. So apply more sunscreen than usual or stay away from the sun at all.
If you have had a reaction to the sun and heat and think it is related to your medicine, let me know.
Did you suffer more than you expected from the heat? It may be caused by your medicine
Oh, we have a minister for that!
Have you ever heard of an MP named Will Queens?
No, me too. But apparently he is the Minister of Children and Families and he is obviously responsible for advocacy on behalf of young people with learning disabilities. Well, I would never understand, despite the fact that I spend most of my days helping vulnerable families in my clinic to try to get vital support for complex needs.
Perhaps his invisibility explains why many parents caring for children with disabilities say they feel abandoned by the government as they try to punch through piles of documents to get help.
This is just another example of a symbolic appointment, an impersonal minister who seems to be doing little to help the people he is supposed to represent. Maybe there are other things going on behind the scenes, but I doubt it.
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