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Rheumatology • General Rheumatology
How do you approach evaluation and management of a patient with recurrent monoarticular inflammatory arthritis of unclear etiology?
Synovial fluid analysis: cell count >100,000, > 80% neutrophils. Gram stain, cultures (including fungal and mycobacterial), synovial biopsy, and crystal analysis are negative. Was treated with IV antibiotics without any improvement.
Answer from: at Community Practice
Routine testing will not identify Lyme disease although the WBC count is higher than usual. If the antibiotic does not target B burgdorferi recurrence might mean inappropriate therapy previously.
WBC count WAAAY too high for mere trauma or internal derangement.
Anything else to suggest psoriasis? ...
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