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55 yo man with monoarthritis of knee joint

3448 Views 7 Replies 4 Participants Last post by  tkourkou
A 55 yo man comes to the ED complaining for recent onset pain in his right knee. This incident happened 2 days after he returned home after an all day long golf game during a hot summer day, followed by meat and beer consumption. Examination reveals a hot, red and swollen knee joint with limited mobility. Examination of the joint fluid has the following characteristics:
-Negative birefringent crystals phagocytosed by leucocytes
-Few red cells
-55,000 WBCs
At which should you aim your treatment?

a) Gout
b) Pseudogout
c) Septic arthritis
d) Medial collateral ligament tear
e) Dehydration
f) Counseling on the dangers of increased sun exposure
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Monosodium Urate cryastals in joint aspirate!

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