Severe knee pain was making it difficult for 65-year-old Don McLendon to get on and off the forklift at work. After years of playing a variety of sports and drag-racing cars, arthritis was aggravating his left knee.
“My knee was bothering me so bad, I had to wear a knee brace and use a cane to walk,” he explains. “I was also having pain and swelling in my left big toe. Both of these issues were interfering with my ability to work.”
Don consulted Dr. Antonio Howard, sports medicine physician with Atrium Health Musculoskeletal Institute. After doing imaging on the spot, Howard diagnosed Don’s condition as gout-related arthritis (also known as a gout flare) in his toe and knee. Howard removed some fluid from his knee joint and injected cortisone into his knee. They also discussed dietary changes to help minimize his gout flares and reduce pain and swelling.
“Part of the reason we did the injection right away is because Don’s very dedicated to his work,” Howard says. “He wanted to return to work as quickly as possible. We thought this would give him the best chance to do so.”
Kidney Disease Challenge
Don was predisposed to gout flares due to his chronic kidney disease. This meant that Howard had to be especially careful about the medication he prescribed. Oral medication can cause further injury to the kidney and, in severe cases, result in kidney failure.
“We usually manage gout flares with oral medication,” explains Howard. “Because of Don’s kidney disease, many of those are not safe for him to take. After oral medication, injections are the next option for managing this type of pain.”
Earlier this year, Don was back to see Howard for a gout flare in his hand. Howard injected his hand with cortisone to provide relief. A few weeks later, Don was back in his office with pain in his hip. (While gout flares in the hip joint are uncommon, they can occur in patients predisposed to recurrent flares.) Howard treated his hip with a cortisone injection.
By the time Howard saw Don for his third gout flare, he knew he had to try another type of treatment. Howard did additional research and discovered that Don could take allopurinol to lower his uric acid (a waste product found in blood) levels. Lowering uric acid helps prevent urate crystals (a by-product of urine) from collecting in the joints and causing pain.
“We have to monitor the dose to make sure it doesn’t cause any harm to his kidneys,” says Howard. “We’re hoping that it will reduce his continued flares and the need for joint injections.”
Don has been doing well on the medication so far.
Types of Arthritis
Arthritis is a broad term for joint inflammation. It comes in a variety of forms, including:
- Degenerative osteoarthritis, which is caused by normal wear and tear on the joints from sports, recreation and daily activities
- Inflammatory arthritis, which includes rheumatoid and psoriatic arthritis as well as gout and pseudogout
Kidney disease makes patients prone to gout and pseudogout. Patients with gout have urate crystals collect in their joints. Patients with pseudogout have calcium crystal deposits collect in their joints. Both types of deposits can cause sudden joint pain and irritation. Gout flares most commonly affect the toe and knee.
Exceptional Care Across Atrium Health
Don has been an Atrium Health patient for more than 10 years. In 2012, Dr. Ornob Roy, a board-certified urologist with Atrium Health who specializes in cancer, kidney disease and surgery, had to remove Don’s left kidney due to kidney disease.
“I spent five days at Atrium Health Carolinas Medical Center for my kidney surgery,” he says. “I had two of the best nurses. From that day on, I’ve had great service at Atrium Health.”
When Don needed help with his knee in late 2022, he chose Atrium Health to ensure continuity of care. But he also made this choice because of the friendly service offered by Atrium Health’s administrative staff.
“They’re very cordial about doing their job, especially when making and rescheduling appointments,” he notes. “They are quick to follow up to see if I need to come back. They’re always kind, courteous and helpful.”
Don also appreciates Howard’s warm bedside manner. “He’s very helpful and knowledgeable,” he says. “He’s also very considerate and communicative, which creates a positive atmosphere for healing. And it doesn’t hurt that he has a good sense of humor.”
Motivated to Stay Active
Now that Don’s pain is gone, he can move around with ease and walk without a cane. He’s currently working as a parts deliverer for a major trucking company, which is much easier on his joints than operating a forklift. Plus, he feels well enough to spend quality time with his children and grandchildren.
“In many ways, Don represents the ideal patient,” notes Howard. “He’s motivated to get better and stay active, which is exactly what sports medicine doctors want. When we can restore function and get patients back to working and living normally, we feel great joy and satisfaction.”
Expert Tools and Technology
Atrium Health Musculoskeletal Institute has the expertise, tools and technology to help patients like Don get back to work pain-free. For example:
- Top-rated hip and knee care. Atrium Health Musculoskeletal Institute has been recognized by U.S. News & World Report as the top 10% in the country for orthopedic care, hip replacements and knee replacements.
- On-site imaging. Patient can get X-rays in the office and have them read by a sports medicine physician immediately. This helps prevent unwanted delays in care.
- Relationship with the lab. A close working relationship with the lab means that physicians can check blood levels and submit specimens for testing quickly and efficiently.
- Ultrasound guidance. Joint experts perform cortisone injections using ultrasound guidance, so they can access the targeted area and deliver a highly precise and effective treatment.
Atrium Health Musculoskeletal Institute has multiple locations throughout Charlotte and the surrounding region, allowing patients to find care that’s close to home. If a patient sees a physician at one location but needs to transfer to another, it’s an easy, seamless process.
Learn more about expert sports medicine care at Atrium Health Musculoskeletal Institute.
