Lab Studies:
WBC 4500/µL, ESR 34 mm/hr, CRP of 2.4 mg/dL. Joint aspiration yielded 120 mL of a cloudy yellow fluid with 24,200 nucleated cells/mm3 with 89% neutrophils, 2000 RBCs/mm3, no crystals, and a negative culture.
Other Studies:
Knee radiographs showed a large joint effusion, normal joint spaces and bones and otherwise negative. Knee MRI showed a moderate-to-large joint effusion with frond-like fatty tissue in the anterolateral knee; synovial proliferation or scarring; and intact menisci, ligaments, and tendons Case Photo #1 Case Photo #2 .
Photo 1: MRI T2 FS axial image of knee at level of superior patella showing the effusion, frond-like fatty tissue at the superolateral patellar pouch.
Photo 2: MRI T2 FS sagittal image of knee at lateral side of knee showing the effusion, frond-like fatty tissue at the superolateral patellar pouch.
Consultations:
He was referred to orthopedic surgery.
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.