Late one evening while watching a movie with the family, I was relaxing in my favorite chair (Dad’s chair). Staying in one position for long is not possible as my joints become stiff and uncomfortable. Constant shifting, stretching, rising up and walking around are needed to avoid the stiffness. My right leg was propped up under the other leg. After 10 or so minutes the urge to stretch the leg out hit me. I flexed the knee and midway through the motion, the joint got stuck. This situation happened in the past but habit kicks in and the urge to continue the flexing motion to relieve the stiffness caused me to push through the catch. A loud pop ensued followed by pain. Even though the surround sound from the movie was loud, the pop was heard by all which was followed by a moan of pain.
I know that my right knee has permanent damage from RA. Last year an MRI ordered by my rheumy confirmed that the articular cartilage, the cartilage on the tip of the leg bones that keeps friction between the bones to a minimum, was eroded to the point where pieces of the soft tissue were frayed and likely floating around in the joint. There are probably places where rough surfaces of the bone are in contact with one another. The loud pop was probably from a piece of frayed cartilage catching on something during the flexing motion. This explains the nearly constant pain that racks my right knee.
One of the most embarrassing moments I’ve experienced in the past couple of years is when I flex my knee in the middle of a meeting during a silent moment and everyone hears it pop loudly. I just smile and act like it’s no big deal. Every time I readjust my leg while in bed, it pops loudly. While certainly the worst offending joint, my knee isn’t the only one that snaps, crackles, and pops. My finger joints regular crunch as I move them. If moved slowly, I can literally feel the tissues moving and grating on one another. My ankles pop constantly. This phenomenon is known as crepitus which is Latin for crackling.[i] There are multiple forms, but articular crepitus, which occurs at the tips of bones, is a common symptom of RA.[ii] As the joint is attacked by inflammation, tissues are degenerated resulting in soft tissue destruction and bone damage.
For me, the crepitus comes and goes depending on the level of inflammation. But this symptom demonstrates that joints are already damaged. Only time will tell how long my right knee will hold out before more drastic measures are needed (I refuse to let my mind go there). For now, the snap, crackle, pop of my joints serve as an audible reminder of RA.
[ii] Ombrest, L., Bisschop, P., & Veer, H. (2003). A System of Orthopaedic Medicine. London, Elsevier.