01-13-2014, 09:45 AM
A previously healthy 14-year-old girl is
brought to the
physician because of a 2-day history of fever and pain
and swelling of the
right knee. She remembers injuring the knee while
playing soccer last
week, but she was able to finish the game. She has no
history of rash or
joint pain. Her sister has inflammatory bowel
disease. The patient's
temperature is 39 C (102.2 F), blood pressure is
110/80 mm Hg, pulse is
95/min, and respirations are 20/min. Examination of
the right knee
shows swelling, tenderness, warmth, and erythema;
range of motion is
limited. Which of the following is the most
appropriate next step in
management?
A
) X-ray film of the right knee
B
) Gastrointestinal series with small-bowel
follow-through
C
) Nuclear scan of the right knee
D
) MRI of the right knee
E
) Antibiotic therapy
F
) Arthrocentesis
brought to the
physician because of a 2-day history of fever and pain
and swelling of the
right knee. She remembers injuring the knee while
playing soccer last
week, but she was able to finish the game. She has no
history of rash or
joint pain. Her sister has inflammatory bowel
disease. The patient's
temperature is 39 C (102.2 F), blood pressure is
110/80 mm Hg, pulse is
95/min, and respirations are 20/min. Examination of
the right knee
shows swelling, tenderness, warmth, and erythema;
range of motion is
limited. Which of the following is the most
appropriate next step in
management?
A
) X-ray film of the right knee
B
) Gastrointestinal series with small-bowel
follow-through
C
) Nuclear scan of the right knee
D
) MRI of the right knee
E
) Antibiotic therapy
F
) Arthrocentesis