QuestionSBA
QuestionChoice
It would be important to take blood cultures in a patient who is febrile with a suspected infection, however, the most urgent task to perform is a joint aspiration for diagnostic purposes.
10036014
c
Take blood cultures
QuestionChoice
This patient likely has a septic joint. Colchicine may be used to help manage pain in an acute monoarthritis, but is not typically used in septic arthritis. The most important step to take is to obtain a joint aspirate.
10036016
e
Commence colchicine
QuestionChoice
The likely diagnosis in this case is septic arthritis given the acute red hot swollen joint and fever. Patients with sickle cell anaemia are susceptible to overwhelming infections, and there is a link between sickle cell anaemia and septic arthritis caused by salmonella. An urgent joint aspirate should be obtained for diagnostic purposes and to ascertain microbial sensitivities.
10036012
a
Joint aspiration
QuestionChoice
This would be inappropriate; the patient has an acute monoarthritis with a fever and septic arthritis must be considered.
10036015
d
Discharge with NSAIDs
QuestionChoice
The most likely diagnosis is septic arthritis. The first step that should be undertaken is a diagnostic joint aspirate. An arthroscopy and washout may be required further down the line if the infection is severe or is not responding to antibiotics.
10036013
b
Arthroscopy and washout
Concept
Chapter
2693
5804
Septic arthritis
Topic
146
Rheumatology
19606
Patients with sickle cell anaemia are at increased risk of septic arthritis, often caused by Salmonella, requiring prompt joint aspiration for diagnosis.
A 23-year-old patient with sickle cell anaemia develops a fever and a red, hot swollen elbow. On examination, they are in excruciating pain on active and passive movement of the joint.

A radiograph of the elbow is normal. The patient's observations are as follows:

* Heart rate: 112 beats/minute
* Blood pressure: 102/69 mmHg
* Respiratory rate: 17 breaths/minute
* Temperature: 38.7 degrees
* Oxygen saturations (room air): 98%

What is the next most appropriate step?
a