Musculoskeletal System: The Daily PANCE Blueprint

Musculoskeletal System: The Daily PANCE Blueprint

A 37-year-old lady comes to the clinic complaining of a painfully swollen left wrist. She first noticed the discomfort just over 24 hours ago, and it has gradually worsened. Accompanying her physical discomfort, she experienced episodes of fever and tremors during the previous night. She reports no known medical conditions and is not on any regular medications, though she does use ibuprofen to alleviate occasional menstrual discomfort. On examination, the mobility of her wrist is noticeably reduced, and it is sensitive to touch. There is clear evidence of fluid accumulation in the joint, which is tender, reddened, and feels warmer than normal. Given the patient's signs and symptoms, what should be the immediate next step in treating her condition?

A. Colchicine
B. Indomethacin
C. IV antibiotics
D. Wrist radiograph
E. Arthrocentesis

Answer and topic summary

The answer is Arthrocentesis

Given the acute onset of pain, decreased range of motion, effusion, and systemic symptoms like fever and chills, this patient may be suffering from septic arthritis, which is a medical emergency. The best next step would be arthrocentesis, which would allow for joint fluid analysis and culture to confirm the diagnosis.

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Covered under ⇒ PANCE Blueprint MusculoskeletalInfectious Diseases and Gout and pseudogout

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