A 38-year-old man comes to the physician because of progressive pain and swelling of his left knee for the past 2 days. He has been taking ibuprofen for the past 2 days without improvement. Four days ago, he scraped his left knee while playing baseball. The pain starts after waking up and lasts for 20 minutes. On examination, the left knee is swollen, erythematous, warm, and tender with restricted range of active and passive motion. The remainder of the examination is unremarkable. Which of the following is the best next step in management of this patient?

Question

A 38-year-old man comes to the physician because of progressive pain and swelling of his left knee for the past 2 days. He has been taking ibuprofen for the past 2 days without improvement. Four days ago, he scraped his left knee while playing baseball. The pain starts after waking up and lasts for 20 minutes. On examination, the left knee is swollen, erythematous, warm, and tender with restricted range of active and passive motion.  The remainder of the examination is unremarkable.  Which of the following is the best next step in management of this patient?

Quizplus · Accepted Answer

Eductional Objective: Synovitis is characterized by pain, erythema, swelling, and reduced range of motion in a joint.  Acute synovitis may represent serious pathology (eg, septic arthritis), especially if accompanied by fever or leukocytosis; it should be evaluated urgently with synovial fluid analysis.

A 38-Year-Old Man Comes to the Physician Because of Progressive