Reactive arthritis Quiz: Ace Your Exams
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A 27-year-old woman presents to the clinic with a two-week history of asymmetric joint pain, particularly in her right knee and left ankle and foot. She had a recent episode of diarrhea, vomiting, and abdominal pain, which resolved on its own. She has no significant past medical history or family history of autoimmune disorders. Temperature is 37.0°C (98.6°F), pulse is 78/min, respiratory rate is 16/min and blood pressure is 118/72 mmHg. On examination, the right knee is swollen and warm. Laboratory tests are listed below. STI screening is negative. Which of the following is the most appropriate next step for managing this patient’s condition?
| Laboratory study | Result | Reference range |
| ESR | 72 mm/hr | 0-20 mm/hr |
| CRP | 3.97 mg/dL | <0.3 mg/dL |
| ANA | Negative | Negative |
| Rheumatoid factor | Negative | Negative |
| HLA-B27 | Positive | Negative |
| Synovial WBC count | 10,000 cells/microL | <200 cells/microL |
| Synovial Gram stain and culture | Negative | Negative |
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