Septic Arthritis: The Daily PANCE Blueprint

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Septic Arthritis: The Daily PANCE Blueprint

A 42-year-old man presents to the clinic with a painful, swollen right knee that started suddenly two days ago. He reports that the knee pain has worsened, and he is now unable to bear weight on that leg. He also notes feeling feverish and experienced chills last night. His medical history is unremarkable except for occasional episodes of heartburn for which he takes over-the-counter antacids. On examination, the right knee is warm, erythematous, swollen, and has decreased range of motion due to pain. What is the most appropriate next step in management?

A. Begin oral naproxen therapy
B. Order a knee MRI
C. Start intravenous antibiotics
D. Perform joint aspiration of the knee
E. Prescribe allopurinol

Answer and topic summary

The answer is D. Perform joint aspiration of the knee.

In a patient presenting with acute monoarticular arthritis accompanied by fever and systemic symptoms, it’s essential to differentiate between septic arthritis and other causes like gout. Joint aspiration (arthrocentesis) is the most appropriate next step, as it allows for analysis of synovial fluid for white blood cell count, Gram stain and culture, and crystal examination. This diagnostic step is critical because septic arthritis requires prompt treatment to prevent joint destruction and systemic complications

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Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Infectious Diseases ⇒ Septic arthritis

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