22/03/2025
( الحالة للتوضيح كيف تكون علميا وشلون نحولها للغة العامية البسيطة وبطريقة مختصرة )
مريضة عمرها بالأربعين
الم شديد بالركبة
الاشعة طبيعية ( ماكو سوفان )
السونار.. مي والتهاب
التحاليل فوك ال٧٥
التشخيص التهاب المفصل ( ماكو اصابه )
العلاج .. سحب السائل وإرساله للزرع وعلاج اولي
Clinical History:
A woman in her 40s presents with an acute onset of right knee pain and swelling, with a duration of less than 2 weeks. The onset was spontaneous, with no preceding trauma or known precipitating events. She denies systemic symptoms such as fever, rash, or recent infections.
Physical Examination:
• The right knee is tender, warm, and swollen on palpation.
• The joint is erythematous, with restricted range of motion due to pain.
• No other joints are involved, and no signs of systemic illness are noted.
Initial Investigations:
1. Ultrasound of the Right Knee:
• Demonstrates joint effusion and synovial hypertrophy, suggestive of active synovitis.
2. Plain Radiograph (X-ray) of the Knee:
• No significant abnormalities; no joint space narrowing, bony erosions, or calcifications observed.
3. Laboratory Investigations:
• Elevated acute phase reactants: ESR = 75 mm/hr
• Elevated CRP (exact value not provided)
Differential Diagnosis:
The clinical and imaging findings raise concern for acute monoarthritis, with the following primary differentials:
1. Inflammatory arthritis – such as early rheumatoid arthritis, reactive arthritis, or a crystal-induced arthropathy.
2. Septic arthritis – must be considered given acute presentation, joint warmth/swelling, and elevated inflammatory markers.
Management Plan:
1. Urgent Arthrocentesis (Knee Joint Aspiration):
• Indicated to evaluate for infection or crystals.
• Synovial fluid should be sent for:
• Gram stain and bacterial culture
• Cell count and differential
• Crystal analysis
• Glucose and protein levels
2. Supportive Measures:
• Relative rest of the affected knee
• Mild elevation of the limb to reduce swelling
• Cold compresses to reduce inflammation
• Analgesia with NSAIDs or acetaminophen for pain relief
#دكتوراحمدالعوادي
ملاحظة.. الحالات التي تنشر خاصة من العيادة وبعد اخذ موافقة المريض