Best Practice Case Studies-Rheumatology

Pdf Summary

The document consists of two study questions related to orthopedic clinical scenarios.

<strong>Study Question #1</strong> addresses the synovial joint fluid analysis in pseudogout. The correct answer is <strong>D. Rhomboid-shaped crystals</strong>. In pseudogout, the synovial fluid analysis will typically show calcium pyrophosphate dihydrate crystals, which are rhomboid-shaped. This is distinct from gout, which shows monosodium urate crystals that are needle-shaped. A WBC count of 50,000 and a positive gram stain are indicative of septic arthritis rather than pseudogout.

<strong>Study Question #2</strong> concerns the application of corticosteroid injections for a patient with knee osteoarthritis. The correct answer is <strong>C. Supra-patellar fat pad and pre-femoral fat pad</strong>. In the lateral supra-patellar approach for intra-articular knee injections, the joint space is located between these two fat pads. This method is noted to have a 91% accuracy rate. Other approaches, such as the lateral mid-patellar, anteromedial, and anterolateral approaches, have lower accuracy rates. Hoffa’s fat pad and Kager’s fat pad are located in different areas, not relevant for this injection technique.

Each question is supported by references from medical literature, including synovial fluid analysis guidelines and studies on needle placement accuracy for knee injections. These questions highlight critical diagnostic and procedural knowledge relevant to joint conditions such as pseudogout and knee osteoarthritis.

Meta Tag

Edition 3rd Edition

Related Case 3rd Edition, CASE 48

Topic Rheumatology

Keywords

pseudogout

synovial fluid

rhomboid-shaped crystals

calcium pyrophosphate dihydrate

corticosteroid injections

knee osteoarthritis

supra-patellar fat pad

pre-femoral fat pad

joint conditions

orthopedic clinical scenarios

3rd Edition

3rd Edition, CASE 48

Rheumatology