Need help diagnosing knee pain without easy access to decent medical care

This happened on Sunday, it is now Wednesday.


So I'm travelling through Vietnam by myself, I'm about 3-4 hours from Saigon, and get into a motorcycle accident (oil slick on the road), that results in my coming down onto the pavement and going for a slide. Initial damage is semi-minor road rash on my arm and can't put any weight on my left knee without massive pain, but no exterior damage to it. Most of the pain seems localized to the inner portion of the knee (mcl?)


Locals take me to the local hospital, which could be a stand-in on a horror movie it's so bad. What looks like a 15yo kid in jeans and an Adidas t-shirt takes an x-ray showing no bone damage. Doc says to rest the knee for a week and sends me off with a stiff knee brace, and a script for Tylenol, an anti-infection, and and an anti-inflammatory (coulda used some pain meds...) Check into a local guesthouse for the night to figure out a gameplan. I'm still at the guesthouse and the owner's have been super kind given the situation, they found one handmade crutch from somewhere for me to hobble around on.


That was Day 0 - extreme pain, unable to twitch my left leg without shooting pain, no sleep whatsoever that night


Day 1 - still in extreme pain, guesthouse owner takes me to a better, but still far from western standards, hospital to recheck . Same diagnosis, asked for an MRI but didn't get one, google translate doesn't work great for Vietnamese but I don't think they had one. The doctor did drain my left knee, took 5 full syringes out. He seemed impressed, not sure what that means. Said to rest for 1-2 weeks.


Day 2 - Feeling a bit better, shooting pains are subsiding a bit, can now put maybe 10% bodyweight on it standing (still with knee brace)


Day 3 - Getting slowly better, I can now put maybe 30% bodyweight on that leg without pain (haven't removed knee brace yet). Can move it around with light pain, but still can't walk on it.


I haven't removed the knee brace to check knee movement as I'm not sure I'll be able to reach the bottom the velcro to put it back on, I think I'll be able to do that tomorrow.


Any ideas on what I'm into here?


For general info, reasonably healthy/in shape 35M, 170lbs

Was there blood in the syringe of the material he took out of the knee? And if so did the knee well up immediately following the crash or over the next 24 hrs or even longer?

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Originally Posted by physiobob

Was there blood in the syringe of the material he took out of the knee? And if so did the knee well up immediately following the crash or over the next 24 hrs or even longer?

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There was blood in there (now I'm fearing how bad that is), probably similar colour to this; Removing fluid from knee - YouTube. Knee swole up immediately after the crash. Was drained maybe 24 hours after.Still a bit swollen, but not terribly, picture taken right now

https://i.imgur.com/dGDxUyv.jpg

It would be great to see the X-ray, but considering there was two opinions and they both said it wasn't broken that could be a good sign.

Blood in the joint, or haemarthrosis could be due to multiple reasons. You're knee is definitely very swollen. Due to not being able to weight bear on the knee, it would be ideal to order a CT scan to check for any minor fractures that didn't show up on X-ray. How long are you in Vietnam for? Other reasons for haemarthrosis could be ligament tears like an ACL.

My advise would be to stay off the leg as much as possible and keep using the crutch - even find two so you could go totally non-weight bearing.

If you need an online consult, I am happy to see you via video consult, I've attached the link for your information:

Hope that helps!
bit.ly/2v6qaHo

I have attached the x-ray, ignore the writing on top as I used a youtube video to get a white screen on my laptop.

https://i.imgur.com/7htPRVn.jpg

Had an MRI today. Good news is ligaments are ok, bad news is I have a tibial plateau fracture