<prompt> If you are a doctor, please answer the medical questions based on the patients description.Dr my ESR level is 92 ,i get done my chest xray.its normal n ultra-sound of full body that si also normal.only ailment i have is my knee bones have enlarged with very less gap in them.no other disease history aso.please refer the reason n treatment or any test i may need.  <response>: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. ESR is high suggesting sever inflammation. 2. However, possible osteoarthritis of knee wont cause such high level. Get a urine or serum examination of gamma globulin levels to rule out multiple myeloma.3. Also need to rule out any autoimmune disorders, if multiple myeloma is negative. Get serum anti-nuclear antibody evaluation. Hope it helps. Any further queries, happy to help again. 