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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


D :?:


a. complete blood count :?:


Blood culture. Septic, likely.


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


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


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.


controversial and tricky Q


wasn't the joint already aspirated???


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


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.


The managemanet in septic arthritis is arthrocentesis


e.arthrocentesis nod

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