Septic arthritis Quiz: Ace Your Exams
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A 73-year-old man presents to the emergency department for evaluation of right knee pain and swelling for the past 2 days. The patient has been unable to ambulate secondary to the pain. Past medical history includes hypertension, gout, diabetes, osteoarthritis, and obesity. Temperature is 38°C (100.4°F), blood pressure is 125/71 mmHg, pulse is 98/min, respiratory rate is 14/min, and oxygen saturation is 99% on room air. On physical examination, there is a palpable effusion, warmth, and marked swelling of the right knee. The patient is unable to bear weight without significant pain. An arthrocentesis is performed. The synovial fluid analysis results from later that day are shown below. Which of the following is the most likely diagnosis?
| Laboratory value | Result | Reference Range |
| Color | Opaque/Cloudy | Clear yellow |
| Culture/Gram stain | Moderate polymorphonuclear cells on Gram stain; No growth on culture thus far | Negative/No growth |
| Cell Count | 77,532 cells/microL, 95% polymorphonuclear leukocytes | <2,000 cells/microL; <25% polymorphonuclear leukocytes |
| Crystal Analysis | Negative | Negative |
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