Painful Knee Effusion In A 42 Year Old Male With Hiv

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Painful Knee Effusion In A 42 Year Old Male With Hiv - Page #3

Lab Studies: Aspiration of synovial fluid demonstrated the following results: 2350 white blood cells; 31,750 red blood cells; negative gram stain and culture; crystal analysis with few needle-shaped negatively birefringent crystals (monosodium urate) Case Photo #1 and few rhomboid-shaped, positively birefringent crystals (calcium pyrophosphate dihydrate) Case Photo #2 . Serum calcium and uric acid were unremarkable. Serum RPR was reactive 1:4 (decreased from prior, no new infection) with positive treponema antibody. Urine Gonorrhea and Chlamydia were negative. Other Studies: Ultrasound of the left knee demonstrated a suprapatellar effusion, seen in both short and long axis views. X-ray of the left knee was unremarkable, with no evidence of fracture or chondrocalcinosis. Consultations: None Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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