vyseerx
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4 years old male child was brought to the ER with complaints of pain in the right knee joint for 2 days. he was limping . on examination the joint was edematous ,erythematous and tender to touch. child was febrile and complained of chills. joint aspirate has shown leukocytosis , predominantly neutrophils. father tells that child was adopted at 2 yearsof age and the immunization status is not known.which is the most appropriate initial step in the management of this child?
a. complete blood count
b.blood culture
c.x-ray of knee joint
d. joint aspirate culture
e.arthrocentesis
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vyseerx
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| asmi
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D :?:
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| alice8
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a. complete blood count :?:
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| Idiopathic
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Blood culture. Septic, likely.
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| bakpity
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It is D. Need to take a sample in order to be able to choose the correct AB and verify the suggested dg.
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| alice8
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i think prior to any kind of invasive procedure you have to check CBC ,to rule out thrombositopenia :!:
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| vyseerx
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sorry guys, you all got it wrong, it is arthrocentesis, which is essential in the mangament of any suspected septic arthritis pt. ref.kaplan material.
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vyseerx
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| alice8
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controversial and tricky Q
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| ayeshah_l
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wasn't the joint already aspirated???
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| marble
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Exactly, the joint was aspirated. I'd say D, if there already is aspirate.
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| Dawg_MD
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The question was worded kinda funny. I got confused because I thought the stem showed that the joint had already been aspirated. Just for future reference though, everything I have read about septic arthritis says that the first step is always an arthrocentesis. I would think from there, since you know there is an infection there, you would treat with a broad spectrum AB while awaiting cultures.
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| webjeee
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i think e first, culture may follows
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| ram3
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The managemanet in septic arthritis is arthrocentesis
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| doc_clotaire
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e.arthrocentesis 
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