Clinical Case Database / Category: Patient Management
Management of the hot swollen joint H in adults in the Emergency Department
Publication details
Ali S M Jawad MSc, FRCP, Jamie Fairweather MSc, MRCS
Foundation Years Journal, volume 9, issue 10, p.38 (123Doc Education, London, November 2015)
Abstract
Though septic arthritis needs to be excluded when a patient is seen as an emergency, other causes of the hot red swollen joint such as gout, pyrophosphate and psoriatic arthritis, palindromic rheumatism and acute sarcoidosis, can be diagnosed with careful history, physical examination and simple investigations. The joint aspirate needs to be Gram stained, cultured and sent for polarised microscopy. Intra-articular corticosteroids should not be injected unless septic arthritis is confidently excluded. Swollen prosthetic joints are best referred urgently to the orthopaedic team.
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Authors
Ali S M Jawad MSc, FRCP (Corresponding author)
Rheumatology Department
The Royal London Hospital,
Bancroft Road, London E1 4DG
ali.jawad@bartshealth.nhs.uk
Jamie Fairweather MSc, MRCS
Whipps Cross Hospital
Whipps Cross Road
London, E11 1NR
jamiefairweather@doctors.org.uk
References
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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