Block 5th Surgery

Jul 17, 2026

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Acute right knee pain with fever, warmth, erythema, swelling, limited active and passive range of motion, and degenerative imaging findings is evaluated in a 62-year-old woman with major comorbidities including hypertension, type 2 diabetes, chronic kidney disease, and diabetic foot ulcers. Arthrocentesis shows cloudy synovial fluid with marked leukocytosis dominated by polymorphonuclear cells and no crystals or bacteria on visualization, supporting septic arthritis. Management prioritizes immediate intravenous antibiotics and adequate drainage via serial needle aspiration to clear purulent material.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages219

Reading Time9 h 12 min

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24679 A 62-year-old woman comes to the emergency department due to a 2-day history of right knee pain and sweling.In the past,the patient hasoccasionally had knee pain brought on by physical activity,but the current episode is more severe and persistent.She has had dificulty bendingthe knee or bearing weight,NSAIDs have provided minimal relief.The patient's other medical conditions include hypertension,type 2 diabetesmelitus,chronic kidney disease,and diabetic foot ulcers.Temperature is 38.4C(101.1 F),blood pressure is 142/84 mm Hg,and pulse is104/min.On physical examination,the right knee is swollen,warm,anderythematous with limited active andpassive range of motion.The leftknee appears normal,but there is mild crepitus on movement.X-rays of the right knee reveal subcutaneous edema,joint effusion,anddegenerative changes.Right knee arthrocentesis yields 5mL of cloudy fluid with a leukocyte count of 55,000/mm³,of which 95%arepolymorphonuclear cells.No bacteria or crystals are visualized.Cultures of the synovial fluid are sent,and empiric antibiotics are begun.Whichof the following additional interventions are most appropriate in management of this patient? · 13 ○A.Antinuclear antibody studiesOB.Cast immobilization of the kneeOC.MRI of the right kneeOD.Serial aspiration of the knee○E.Oral prednisone therapyOF.Total right knee arthroplasty · 14 · 15 · 21 Submit · 24 2 4 6 7 9 · 14 · 15 · 18 · 20 · 21 A 62-year-old woman comes to the emergency department due to a 2-day history of right knee pain and swelling.In the past,the patient hasoccasionally had knee pain brought on by physical activity,but the current episode is more severe and persistent.She has had ificulty bendingthe knee or bearing weight;NSAIDs have provided minimal relief.The patient's other medical conditions include hypertension,type 2 diabetesmellitus,chronic kidney disease,and diabetic foot ulcers.Temperature is 38.4 C(101.1 F),blood pressure is 142/84 mm Hg,and pulse is104/min.On physical examination,the right knee is swollen,warm,and erythematous with limited active and passive range of motion.The leftknee appears normal,but there is mild crepitus on movement.X-rays of the right knee reveal subcutaneous edema,joint effusion,anddegenerative changes.Right knee arthrocentesis yields 5mL of cloudy fluid with a leukocyte count of 55,000/mm³,of which 95%arepolymorphonuclear cell.No bacteria or crystals are visualized.Cultures of the synovial fuid are sent,and empiric antibiotics are begun.Whichof the following additional interventions are most appropriate in management of this patient? ○A.Antinuclear antibody studies(6%)OB.Cast immobilization of the knee(1%)○C.MRI of the right knee (28%) √○D.Serial aspiration of the knee(46%)○E.Oral prednisone therapy(12%)○F.Total right knee arthroplasty(4%) Omitted Correct answer D Explanation 46% Answered correctly 06/12/2020 Last Updated ☆ Settings | 1
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Jul 17, 2026

Upload by Aurelia