QuestionSBA
QuestionChoice
Whilst this would also present with an acutely hot swollen joint, it is not the most important diagnosis to exclude immediately as it would not cause as much harm as undiagnosed septic arthritis. A past medical history of rheumatoid arthritis is also a risk factor for developing septic arthritis.
10003677
b
A flare-up of rheumatoid arthritis
QuestionChoice
A patient that has presented with an acutely hot swollen joint that is showing signs of systemic unwellness, such as haemodynamic instability and a raised temperature, should immediately have investigations to rule out septic arthritis. This is done through a joint aspiration for microscopy, culture and sensitivity. Early diagnosis is crucial to prevent the development of sepsis and subsequent death.
10003676
a
Septic arthritis
QuestionChoice
Whilst this would also present with an acutely hot swollen joint, it is not the most important diagnosis to exclude immediately as it would not cause as much harm as undiagnosed septic arthritis. Gout is also more common in older men and most commonly affects the big toe, whereas this patient is a 35-year-old woman with a swollen knee.
10003678
c
Gout
QuestionChoice
This would cause a swollen and tender knee and reduced movement. In addition, the patient would be unable to straighten the knee and may have a hypermobile patella. It is less likely to be erythematous and would likely be bruised instead. It would also not cause as many systemic symptoms as septic arthritis.
10003680
e
Knee dislocation
QuestionChoice
Whilst this would also present with an acutely hot swollen joint, it is not the most important diagnosis to exclude immediately as it would not cause as much harm as undiagnosed septic arthritis.
10003679
d
Pseudogout
Concept
Chapter
2693
4189
Septic arthritis
Topic
145
Orthopaedics
13282
A 35-year-old female with a past medical history of rheumatoid arthritis presents to A&E with an erythematous, swollen, tender left knee.

On examination, it is warm and tender across the entire left knee and there is a reduced range of all movements. The examination of the right knee was unremarkable.

Her basic observations show:

* O2 sats - 96% on room air
* Respiratory rate - 25 breaths per minute
* Blood pressure - 110/75 mmHg
* Heart rate - 130 bpm
* Temperature - 37.9 degrees Celcius.

What is the most important diagnosis to exclude?
a