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Pt. returned from vacation; he is hypertensive on thiazide. He now complains of pain, swelling of Rt. Knee joint & fever. Best manag. is ?
a. -Knee aspiration
b. -Serum uric acid level
Thanks.
mimi222 Forum Junior
Topics: 3 Posts: 29
10/22/06 - 07:56 PM
#2
a is true .in monoarthritis we always go for aspiration first.
Guptashutosh Forum Elite
Topics: 35 Posts: 354
10/26/06 - 04:25 AM
#3
uric acid level first , since pt has a drug history of thiazides which may predispose to increase uric acid level.. secondly knee asp is a invasive procedure GL
chemamr Forum Hero
Topics: 703 Posts: 4,488
10/26/06 - 04:38 AM
#4
maybe A, because serum uric acid can be normal in acute gout attacks.
AAzad Forum Guru
Topics: 57 Posts: 460
10/26/06 - 10:43 PM
#5
BETWEEN A & B WHICH ONE DO U THINK IS LESS INVASIVE , AND ALSO HOW LONG DO U NEED TO WAIT FOR CHEMISTRY LAB RESULT? 10 MIN. CHOICE C WILL BE ALSO GOOD WHICH IS NSAID, BUT DOES GOUT CAUSES FEVER? ANY WAY GOUT OR SEPTIC I GO WITH ASPIRATION. Gout usually develops in the joint of the first toe (i.e., the big toe, or hallux). Common symptoms include the following:
Inflammation Pain Redness Stiffness Swelling Touching or moving the toe may be intensely painful and patients often say that having as much as a bed sheet over the toe increases the pain. Symptoms of gout develop quickly (sometimes in 1 day) and typically occur in only one joint at a time. Rarely, symptoms develop in two or three joints simultaneously. If widespread symptoms occur, the condition is probably not gout. If left untreated, gout can damage joints and cause disability. Diagnosis of gout involves inserting a needle into the affected joint and drawing a sample of the fluid that lubricates the joint (called synovial fluid). The fluid is then analyzed under a microscope to determine if uric acid crystals are present. To rule out joint infection, the fluid also is examined for the presence of bacteria.
Patients with gout have elevated blood levels of uric acid (hyperuricemia), but this condition may or may not be present during an acute attack.
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