History: A man in his early 40’s presents with 1 month of bilateral hand, wrist, elbow, shoulder, knee and ankle pain.  He denies injury, fever or other symptoms.  He denies recreational drugs but does smoke a little and drinks socially.

Exam: Vital signs are normal .   Exam is normal except for swollen hands and knees, especially the left knee

Relevant Test Results:

  • Labs: CBC and BPM normal.  ESR 30, CRP 3
  • Imaging: hands and L knee negative except for knee effusion

 

What is the most likely diagnosis?

  • A) CHF
  • B) RA
  • C) GC
  • D) SBE
  • E) Allergy

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

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QUIZ ANSWER:

  • A) CHF
  • B) RA – CORRECT – knee tap showed 18,000 WBC and no crystals or bacteria.
  • C) GC
  • D) SBE
  • E) Allergy

 

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CASE CONCLUSION: