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    BA Ong
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    A 43-year-old male cook presented to the emergency room with sudden onset of right knee swelling and severe pain over the past 5 days without trauma. He has a 3-year history of gouty arthritis but self-medicating provided no relief. On examination, he could not move his knee without pain. Laboratory tests showed elevated inflammatory markers. Arthrocentesis of the knee joint found pus and gram-positive cocci, confirming the diagnosis of septic arthritis. The next step in management is to treat with antibiotics.

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    A 43-year-old male cook presented to the emergency room with sudden onset of right knee swelling and severe pain over the past 5 days without trauma. He has a 3-year history of gouty arthritis but self-medicating provided no relief. On examination, he could not move his knee without pain. Laboratory tests showed elevated inflammatory markers. Arthrocentesis of the knee joint found pus and gram-positive cocci, confirming the diagnosis of septic arthritis. The next step in management is to treat with antibiotics.

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    © All Rights Reserved
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    24 views8 pages

    Adult - Paper Case - For Students

    Uploaded by

    BA Ong
    A 43-year-old male cook presented to the emergency room with sudden onset of right knee swelling and severe pain over the past 5 days without trauma. He has a 3-year history of gouty arthritis but self-medicating provided no relief. On examination, he could not move his knee without pain. Laboratory tests showed elevated inflammatory markers. Arthrocentesis of the knee joint found pus and gram-positive cocci, confirming the diagnosis of septic arthritis. The next step in management is to treat with antibiotics.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 8

    VD 43/M

    • Works as a cook
    • Known case of gouty arthritis for 3 years
    • 5 days PTC – sudden onset of R knee swelling with no
    history of trauma. He had difficulty ambulating and
    was unable to move his knee without pain (NRS
    10/10). He self medicated with pain relievers but had
    no relief, which prompted consult at the ER
    • (-) fever, (-) weight loss, (-) systemic symptoms
    • Non-smoker, denies illicit drug use, married and denies
    promiscuity
    Guide Questions

    1. What are the important things we already know


    about this patient and why are they significant?

    2. What are the other things you would be


    asking the patient or about the patient?
    Why would you need to know these things?
    Guide Questions

    3. Pls describe what you


    see?

    4. What are the things


    we need to know or
    questions that need
    to be answered
    regarding the status
    or condition of the
    knee?

    5. What
    steps/maneuvers do
    we do to answer
    question # 4
    Guide Questions

    6. What would you be doing next for this patient?


    7. Pls describe your Xray findings
    CBC
    • Hgb 147 • ESR 52
    • Hct 40.7 • CRP >12
    • WBC 11.2 • Uric Acid 5.7 mg/dl
    – Neut 74%
    – Lymph 25%
    – Mono 1%
    8. What is the likely diagnosis?

    9. What’s next in the patient’s management


    Arthrocentesis
    GS/CS Cytology
    • Pus cells +3 • Yellow, turbid
    • Gram (+) cocci: Few • WBC > 50,000/mm3
    • PMN > 75%
    • No crystals seen

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