The Painful, Edematous Knee

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The Painful, Edematous Knee - Page #3

Lab Studies: Lyme, Western blot, synovial fluid: positive IgG and IgM Lyme titers (10/10 IgG, 3/3 IgM) Crystals, synovial fluid: positive for calcium pyrophosphate dihydrate crystals; negative for monosodium urate crystals Synovial fluid culture and gram stain: rare white blood cells, no organisms seen, no growth Cell count, synovial fluid: 18,502 nucleated cells Other Studies: X-ray left knee: No significant degenerative change, joint space narrowing, osteophyte formation, malalignment or obvious fracture. Moderate joint effusion. MRI of left knee: presence of large joint effusion with mild synovitis and scattered intra-articular debris Case Photo #3 . Increased T2 signal on the undersurface of the posterior horn of the lateral meniscus suggesting undersurface tear Case Photo #2 . Cruciate and collateral ligaments appear normal. No involvement of left medial meniscus. Mild thinning of medial compartment articular cartilage. Consultations: Sports Medicine Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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