USMLE Forum Archives - USMLE Step 2 CK - knee pain
knee pain
ysemak - 01-05-10 23:00
A 25-year-old man comes to the physician because of the rapid onset of pain and swelling of his left knee, which began 24 hours ago. His temperature is 38.5 C, blood pressure is 125/70 mm Hg, pulse is 95/min, and respirations are 20/min. His personal history is significant for IV drug abuse. He denies a history of sexually transmitted diseases. The left knee is tender, swollen, and warm to the touch. Chest auscultation is normal.
Which of the following is the most appropriate next step in management?
ysemak - 01-05-10 23:00
A 25-year-old man comes to the physician because of the rapid onset of pain and swelling of his left knee, which began 24 hours ago. His temperature is 38.5 C, blood pressure is 125/70 mm Hg, pulse is 95/min, and respirations are 20/min. His personal history is significant for IV drug abuse. He denies a history of sexually transmitted diseases. The left knee is tender, swollen, and warm to the touch. Chest auscultation is normal.
Which of the following is the most appropriate next step in management?
The correct answer and explanation will be available after you answer.
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#1
Re: knee pain conym5 - 01-06-10 08:29 My answer is: e.
In Pt's with arthritis, joint aspiration is most often performed to differentiate bacterial (septic) arthritis from other inflammatory conditions. Empiric antibiotic therapy is administered promptly after aspiration in all patients with signs and symptoms suggestive of septic arthritis until culture results are available.
#4
Re: knee pain conym5 - 01-07-10 10:36 we can try with NSAID's when Patient has no history of IV drug abuse and on physical examinaion mild erythema or none.
a. Blood studies including complete blood count ans will be next step after orthrocentesis..
#16
Re: knee pain ammulufy - 03-20-10 19:41 My answer is: b.
His history is sigfig with IV drug abuse.....hence we shud immediately screen the patient for his HIV status before instituting any kind of treatment to reduce the risk of transmission to others....and always monoarticular septic arthritis has been the frst symptom manifestation of a HIV positive ptnt.
#17
Re: knee pain ammulufy - 03-20-10 19:44 But knowing the HIV status of the ptnt is essential because of the positive history of IV drug abuse n moreover we also have to safeguard others frm getting infected by this most essential preventive measure,if not taken now the spread of the disease can hav a heavy toll and leave many infected.
#20
Re: knee pain conym5 - 03-26-10 09:04 In Pt's with arthritis, joint aspiration is most often performed to differentiate bacterial (septic) arthritis from other inflammatory conditions. Empiric antibiotic therapy is administered promptly after aspiration in all patients with signs and symptoms suggestive of septic arthritis until culture results are available.
#25
Re: knee pain babbu5508 - 05-23-10 03:28 My answer is: e.
The following are generally accepted indications for diagnostic arthrocentesis (3):
Unexplained arthritis with synovial effusion
Suspicion of septic arthritis
Suspicion of crystal-induced arthritis
Evaluation of therapeutic response in septic arthritis
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