Septic arthritis and transient synovitis (pediatrics) Quiz: Ace Your Exams
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A 3-year-old boy is brought by his parents to the emergency department for evaluation of a limp. The parent reports that the symptoms were preceded by a cough and congestion one week ago. The patient has no significant past medical history and does not take any medication. He is up-to-date on his vaccinations. Temperature is 38°C (100.4°F), blood pressure is 91/46 mmHg, pulse is 142/min, respiratory rate is 20/min, and oxygen saturation is 97% on room air. On physical examination, the patient is comfortable and in no acute distress. There is limited range of motion at the right hip secondary to pain. He can bear weight on the lower right extremity. An ultrasound of the right hip demonstrates evidence of a moderate effusion. Blood work and arthrocentesis are obtained, and results are shown below. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 12.8 g/dL |
| Leukocyte count | 13,100/mm3 |
| Platelet count | 320,000/mm3 |
| CRP | 0.2 mg/dL |
| ESR | 6 mm/h |
| Synovial fluid analysis | |
| Gram stain, culture | Negative, no growth |
| Fluid | Clear, yellow |
| Cell count | 6500 WBC/mm3 |
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