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Knee osteoarthritis — CCFP MCQ

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HardMusculoskeletal and sportsKnee osteoarthritisCCFP

A 58-year-old has an acutely hot swollen knee, fever and inability to bear weight. He is stable, has no overlying cellulitis and can undergo aspiration immediately. What should happen next?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: BObtain synovial fluid and blood cultures, then start empiric intravenous antibiotics

Explanation lettering: E = shown as A · A = shown as B · B = shown as E

A is correct. Septic arthritis is limb- and life-threatening; in a stable patient, immediate aspiration and cultures should precede prompt empiric antibiotics without meaningful delay. B assumes gout despite systemic features. C suppresses immunity and ignores possible coexisting crystals and infection. D uses a nondiagnostic serum test. E delays source sampling and treatment. Orthopedic drainage strategy follows the clinical and synovial findings.

Reference: HealthLink BC: Infectious arthritis: https://www.healthlinkbc.ca/healthwise/infectious-arthritis Alberta Precision Laboratories: Joint-fluid culture collection: https://www.albertahealthservices.ca/webapps/labservices/indexAPL.asp?details=true&id=9631&tests=&zoneid=1