A 57-year-old man presents with a swollen right knee

A 57-year-old man presents with a swollen right knee. He has a history of arthritis and has noted pain and swelling of this knee for a few days. The swelling worsened and he noticed that the knee felt hot. He has some mild nausea.

On today's visit, his temperature is 103.3 °F (39.6 °C) and his white blood cell count is normal. The knee is warm, slightly swollen, and erythematous. Aspiration of the knee joint was performed, but only a few drops of fluid were obtained.

What is the most appropriate next step?

• Delay antibiotic coverage until more fluid is obtained.
• Discard the sample because the scant amount will have a low yield.
• Reattempt the joint aspiration.
• Test the fluid for bacterial cultures.

This question appears in Med-Challenger Family Medicine Exam Review with CME

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