A 72-year-old woman presents CTAS 3 with acute atraumatic knee pain and fever. Temperature is 38.4°C, HR is 108, the knee is hot with a large

Question

A 72-year-old woman presents CTAS 3 with acute atraumatic knee pain and fever. Temperature is 38.4°C, HR is 108, the knee is hot with a large effusion, and she cannot bear weight. She takes apixaban for atrial fibrillation. What is the most appropriate next step?

Accepted Answer

Perform urgent arthrocentesis for synovial fluid analysis before antibiotics if feasible

Answer

Apply a knee immobiliser and discharge

Answer

Avoid arthrocentesis because she takes apixaban

Answer

Start oral prednisone for presumed gout without aspiration

Answer

Order outpatient MRI before sampling the joint

Septic arthritis — RCPSC EM MCQ

A 72-year-old woman presents CTAS 3 with acute atraumatic knee pain and fever. Temperature is 38.4°C, HR is 108, the knee is hot with a large effusion, and she cannot bear weight. She takes apixaban for atrial fibrillation. What is the most appropriate next step?