Painful knee joint

Question 1

What specific information should be elicited in the history?

Answer 1

1. Trauma
2. Fever
3. PMH of RA, Gout or Haemophilia

Question 2

What further examinations or investigations would you carry out?

Answer 2

Examine other joints

Plain film of knee (AP and Lateral)

Joint aspiration

Question 3

What are you looking for in joint aspiration analysis?

Answer 3

Cells
Sugar
Protein
Culture

Question 4

How may lyme disease present?

What test confirms diagnosis of lyme disease?

Answer 4

Painful knee joint + Unilateral facial nerve palsy + Annular rash

Antibody titre against BORRELIA BURGDORFERI

Question 5

What are the causes of ACUTE monoarticular arthritis?

Answer 5

Bacterial infections (Staph, Neisseria, Strep)
Reactive arthritis
Sarcoidosis
Fracture
Haemarthrosis
Gout
Pseudogout
Monoarticular Rheumatoid arthritis

Question 6

What are the causes of ACUTE polyarticular arthritis?

Answer 6

Endocarditis
HIV
Acute Hep B
Parvovirus
Rheumatic fever
Rheumatoid arthritis
SLE