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Any thoughts?

mlt1862

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Sep 30, 2018
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Hello, and thank you for taking the time to read this. I’ll try to be brief - I’m male and about to be 40 next month.

About 8 months ago I felt a sharp pain in my right knee. It wasn’t a debilitating pain, just annoying. What I also realized was that my right quad muscle had noticeably shrunk. Walking upstairs quickly became a full body exercise, and walking downstairs was even more difficult - but only on my right leg. I tried going to the gym to rebuild my strength, and I literally could not lift 2.5 pounds with my right leg - even with 100% effort, whereas I could lift 60 easily with my left.

I went to my GP who gave me a steroid shot and drained some swelling in my knee. This really had no impact. Xrays showed no damage, and an MRI showed some cartilage damage. I went ahead and had a scope on the knee about 4 months ago. It Helped with some (but not all) knee pain, but the strength in my leg has not returned even after months of PT. I had an MRI of my neck to see if there was any spinal issues there, which came back clear.

I’ve now lost around 15 pounds, but it all seems to be from my right leg. I have an odd gait now, and my left calf is cramping up nightly because of the added strain... I think. Also, I now have twitching my right quad that after some time has spread to my left leg and to now what is either my diaphragm or abdominal muscles.

The twitching led me to the internet “diagnosis.” Just looking for thoughts from someone who isn’t WebMD or Google U.
 

Nikki J

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Mar 22, 2012
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7,373
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PALS
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04/2014
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US
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MA
Well your quad would be a very unusual place for ALS to start. I gather your worry is the injury to to the knee was due to unnoticed but pre existing weakness in the quad?

I do suggest going back to the doctor for an evaluation because something isn’t right but there are a lot of things that could be causing this so don’t focus on ALS. Who ordered the mri? And what did the pt think?
 

KarenNWendyn

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Jul 29, 2017
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PALS
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07/2017
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Even a seemingly small amount of cartilage damage in the knee can be associated with muscle loss around the knee. The fact there was fluid in the knee indicates that cartilage damage is having a considerable impact. PT and ongoing rehab are the way to manage it, but that knee will likely always be weaker.

Leg onset ALS usually starts in a foot rather than in the quadriceps.

Twitching is common, nonspecific, and meaningless in the absence of muscle function failure.

So I don’t believe you have ALS.
 

mlt1862

New member
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Sep 30, 2018
Messages
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Diagnosis
00/0000
Country
US
State
TX
Well your quad would be a very unusual place for ALS to start. I gather your worry is the injury to to the knee was due to unnoticed but pre existing weakness in the quad?

I do suggest going back to the doctor for an evaluation because something isn’t right but there are a lot of things that could be causing this so don’t focus on ALS. Who ordered the mri? And what did the pt think?
I was referred to an orthopedic doctor who ordered the MRI. The orthopedic doctor just told me the other day that I have a “unique” case because I’m not responding to PT.
 

Kristina1

Senior member
Joined
Jan 26, 2017
Messages
590
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PALS
Diagnosis
03/2017
Country
US
State
MA
I agree with Nikki, I think your concern is valid but there could be any number of things causing your symptoms and you should get your doctors to do more testing to try and figure out what's going on.
 
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