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septic arthritis

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13 Posts

vyseerx

Forum Guru

Topics: 165
Posts: 378

Jan 30, 2004 - 5:44 PM

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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asmi

Forum Hero

Topics: 1049
Posts: 4620

Jan 30, 2004 - 8:15 PM

D :?:

alice8

Forum Guru

Topics: 37
Posts: 643

Jan 31, 2004 - 3:54 PM

a. complete blood count :?:

Idiopathic

Forum Guru

Topics: 19
Posts: 639

Jan 31, 2004 - 4:02 PM

Blood culture. Septic, likely.

bakpity

Forum Senior

Topics: 28
Posts: 71

Feb 01, 2004 - 2:23 AM

It is D. Need to take a sample in order to be able to choose the correct AB and verify the suggested dg.

alice8

Forum Guru

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Posts: 643

Feb 01, 2004 - 4:45 PM

i think prior to any kind of invasive procedure you have to check CBC ,to rule out thrombositopenia :!:

vyseerx

Forum Guru

Topics: 165
Posts: 378

Feb 01, 2004 - 8:12 PM

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.

alice8

Forum Guru

Topics: 37
Posts: 643

Feb 02, 2004 - 9:06 AM

controversial and tricky Q

ayeshah_l

Forum Elite

Topics: 29
Posts: 284

Feb 11, 2004 - 2:31 PM

wasn't the joint already aspirated???

marble

Forum Newbie

Topics: 2
Posts: 13

Jun 19, 2004 - 1:51 PM

#10

Exactly, the joint was aspirated. I'd say D, if there already is aspirate.

Dawg_MD

Forum Newbie

Topics: 0
Posts: 3

Jul 07, 2004 - 2:31 PM

#11

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.

ram3

Forum Newbie