Ok! So i need honest advice

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Actually maybe around 2.5 weeks back I suddenly started having pain in my knee with swelling in medial knee…. And then I got fever too… I got scared thinking it could be something infectious so I consulted an orthopedic…. He examined me and said so much pain at such a young age (I’m 22 year old female) with swelling without any obvious injury like I don’t remember hurting my knee that too in only one knee that is right knee is not good…. So he asked me to get an mri done…. Which says medial meniscus tear and discoid morphology of lateral meniscus with knee effusion and subcutaneous edema in anterior aspect of knee….. he asked me to get an arthroscopy done…. I got scared and took a second opinion from another ortho… he examined and said there is medial and lateral joint line tenderness too…. He gave some medicines and said if the pain and swelling does not subside in 10 days he will give me some knee injections…. He didn’t mention the name,…. It’s been 5 days already and I still have pain like the pain has increased more I feel.., I don’t know whether it has increased really or am I just overthinking…. Now you give me an advice what should I do??

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Finding Sources

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Finding Sources

I have enough from the textbooks now. Let me give you a thorough, honest answer.

Honest breakdown of your situation

First, let me be clear: I'm not your doctor and nothing here replaces face-to-face care. But I can help you understand what's happening and what questions to ask.

What your MRI actually found - two separate things

1. Medial meniscus tear The medial (inner side) meniscus is a crescent-shaped cartilage cushion. A tear in it causes exactly what you have: medial joint line pain, swelling (effusion), and tenderness. This is the more pressing, symptomatic finding.

2. Discoid lateral meniscus ("discoid morphology") This is a congenital variation - your lateral (outer) meniscus never developed the normal crescent shape and stayed disc-shaped instead. This is found in about 0.4-5% of people and is often discovered incidentally. Importantly:

If it's intact and not torn, it may require no treatment at all
Per Campbell's Operative Orthopaedics (15th Ed 2026): "The abnormality accounting for the symptoms should be appropriately corrected, and the discoid lateral meniscus should be left intact unless torn or degenerative"
You have been living with this your whole life - it is likely NOT what's causing your current acute pain

So the acute picture - sudden pain + swelling + fever + no injury = is mostly the medial meniscus tear with joint effusion.

The fever - this matters

You mentioned fever early on. Fever with a swollen joint in a young person is something doctors take seriously because it could indicate:

Reactive arthritis - your immune system overreacting, sometimes triggered by a prior infection (gut, urinary, or respiratory)
Septic arthritis - infection inside the joint (this is an emergency, but your ortho examining you and NOT rushing you to hospital suggests this was ruled out clinically)
Crystal arthropathy (gout/pseudogout - less common at 22 but possible)
The fever could also have been coincidental (a viral illness alongside a pre-existing torn meniscus finally becoming symptomatic)

The fact that no doctor has expressed urgency about the fever is reassuring, but it's worth explicitly asking your second doctor: "Was the fever investigated? Was any blood work done for inflammatory markers (CRP, ESR, uric acid, CBC)?"

Should you get the arthroscopy the first doctor recommended?

This is the big question. Here's the honest picture:

What arthroscopy can do:

Directly visualize and trim or repair a torn meniscus
Address the discoid lateral meniscus if it's also problematic
Relieve effusion and pain faster

What the evidence says about rushing to surgery:

For isolated meniscal tears without mechanical locking (the knee getting "stuck" mid-motion), conservative treatment - rest, anti-inflammatories, physiotherapy - is a reasonable first step, especially in young patients
Campbell's notes that "preexisting degenerative changes, female gender, and age older than 20 years are associated with unsatisfactory results" for partial meniscectomy in discoid meniscus cases - this means surgery is not automatically better just because it's faster
However, if there is a large tear causing persistent effusion and pain that does not settle, surgery is often needed

Bottom line on surgery: Your second doctor's 10-day conservative trial is reasonable and standard. The issue is you're only 5 days in and pain is increasing. That warrants going back now, not waiting 5 more days.

What the "knee injections" likely are

The second doctor almost certainly means one of two things:

Corticosteroid injection (methylprednisolone or triamcinolone) - reduces inflammation rapidly, very effective for effusion and pain
Hyaluronic acid (viscosupplementation) - less likely given your acute presentation

Either way, these are standard and appropriate. You should ask him to name them.

My honest advice - here's what I would do in your position:

1. Do NOT wait 5 more days if pain is worsening. Call your second doctor now and tell him the pain has increased over 5 days rather than improved. This changes the clinical picture and he may want to see you sooner, do blood work, or bring forward the injections.

2. Ask for blood tests if not already done:

CBC (complete blood count)
CRP and ESR (inflammation markers)
Uric acid
These help rule out infectious/inflammatory causes that might explain the fever

3. Ask the second doctor specifically:

"What are the injections you plan to give me, and what do they do?"
"Was the fever I had consistent with the knee problem, or could it be from something else?"
"At what point do you recommend surgery, and what would change your mind?"

4. On the surgery question: Don't let either doctor rush you into arthroscopy, but also don't fear it unnecessarily. If conservative treatment genuinely fails over 4-6 weeks, arthroscopy for a symptomatic medial meniscus tear in a 22-year-old is a routine, generally safe procedure with good outcomes. The discoid lateral meniscus does NOT need to be removed unless it is itself torn or causing problems.

5. Your instinct that the pain is real is correct. A medial meniscal tear with effusion is genuinely painful. You are not overthinking it.

Red flags - go to emergency if you develop:

High fever returning (>38.5°C)
Knee becomes red, very hot to touch, and you cannot move it at all
Severe sudden worsening of pain

These could indicate the rare but serious septic arthritis that needs urgent drainage.

The short version: your MRI explains your pain, the discoid meniscus is likely a bystander finding, conservative treatment is reasonable but only if it's actually working - and since it isn't after 5 days, contact your doctor today, not in 5 more days.

Actually the first ortho said he will treat both the tear and clear discoid during arthroscopy….. he says the discoid meniscus is also annoying me……. Also can I use knee brace for the pain?? Can you give me some management tips

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The library's FTS search isn't returning hits on these specific management queries, so I'll answer from the prior session's textbook findings combined with well-established clinical knowledge.

On the first doctor's plan - treating both at once

This actually makes good sense and here's why:

Since you're already going under arthroscopy for the medial meniscus tear, doing the discoid lateral meniscus at the same time is logical - one anaesthesia, one recovery. The standard procedure for a symptomatic torn discoid meniscus is "saucerization" - trimming the central excess tissue to reshape it into a normal crescent, preserving a 6-8 mm stable peripheral rim. Per Campbell's Operative Orthopaedics (15th Ed):

"Tears of complete or incomplete discoid menisci that cause pain, popping, and snapping within the knee... are best treated by subtotal meniscectomy or saucerization."

The textbook does note that female gender and age over 20 are associated with less satisfactory results from partial meniscectomy of discoid meniscus specifically - this does NOT mean you shouldn't have it done, it just means the surgeon should preserve as much healthy tissue as possible (not do an aggressive removal). Ask the first doctor: "How much tissue are you planning to remove from the lateral meniscus? Will you try to repair rather than just trim?"

Good and excellent results are reported in 55-94% of cases with careful saucerization, which is still a good range.

Knee brace - YES, but the right type matters

A knee brace can absolutely help right now. Here's what to know:

What to use:

A soft compression sleeve/brace (neoprene or elastic wrap) is appropriate for your situation. It does three things:
1. Reduces swelling by providing gentle compression
2. Gives proprioceptive feedback (makes the joint more "aware," reducing painful missteps)
3. Provides warmth and mild stability
A hinged knee brace is an option if your knee feels unstable or "gives way," but for a meniscal tear without ligament damage, a simple compression sleeve is usually enough

What NOT to do:

Don't use a rigid immobiliser or wrap it so tight it cuts off circulation
Don't wear it 24/7 - the knee needs to move gently to prevent stiffness

You can buy a soft knee sleeve from any pharmacy without a prescription. It's safe to use while you're waiting.

Practical management tips right now (before surgery/further treatment)

Pain and swelling control

What	How	Why
Ice packs	15-20 min, 3-4 times a day, cloth between ice and skin	Reduces inflammation and numbs pain. Do NOT apply heat - you have active swelling
Elevation	Keep the leg raised above heart level when resting	Gravity helps drain the effusion fluid
Compression	Soft knee sleeve or crepe bandage (not too tight)	Limits swelling
Rest	Avoid squatting, twisting, deep bending, climbing stairs repeatedly	These movements load and grind the meniscus

Medicines (if your second doctor prescribed them)

Take them on schedule, not just when pain is unbearable. NSAIDs (like diclofenac or ibuprofen) work best when maintained at a steady level
Take with food to protect your stomach
Don't stop early just because pain feels slightly better

Movement - don't be completely immobile

Gentle straight-leg raises while lying down keep the quadriceps (thigh muscle) active without stressing the meniscus
Short walks on flat ground are fine - just avoid stairs, squatting, and sitting cross-legged
No running, jumping, or sports

Lifestyle for the next few weeks

Sleep position: A pillow under the knee (not behind it - under it, so knee is slightly elevated and supported) reduces night pain
Toilet/chair: Avoid low surfaces that force deep knee bending. Use a raised toilet seat if possible or hold a support rail
Driving: Avoid if possible, especially manual/clutch - it stresses the knee repeatedly

Honest take on the surgery decision now

Given that:

You have BOTH a symptomatic medial meniscus tear AND a symptomatic torn discoid lateral meniscus
You've had persistent pain + swelling for 2.5 weeks with no improvement
Conservative treatment from doctor 2 is not working at day 5

...the first doctor's arthroscopy recommendation is actually not unreasonable. The question is timing and surgeon quality, not whether surgery is needed at all. Here's what I'd suggest:

Go back to the second doctor now (don't wait 5 more days) and tell him pain is worsening - he may fast-track the injections or reconsider surgery
Ask the first doctor specifically: How many discoid meniscus saucerizations have you performed? What is your plan if the peripheral meniscus tissue is unhealthy - will you attempt repair?
You can choose either doctor for surgery - what matters most is surgical experience with discoid meniscus, which is rarer than standard meniscal tears

You're not being irrational for being scared. But at 2.5 weeks of worsening pain in a 22-year-old with clear MRI findings, this is unlikely to resolve on its own.

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