6 yr old female brought to clinic for acute onset of left knee swelling and pain first noticed this morning. Only other symptom is vague abdominal pain and dry cracked lips. No significant family or PMH, not taking any medicstions, no trauma, no fevers or chills, no rashes. Exam benign besides large effusion. CBC unremarkable. Thoughts?

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Do usg of the knee first .reactive arthiritis/septic arthiritis

Advise aspiration of joint fluid Do microscopy and culture Sepsis profile Usg of joint Give symptomatic treatment No need to give antibiotic unless febrile

Transient Synovitis/ Acute exacerbation of underlying pre existing JRA/ Haemocoagulopathic Arthritis, can be the probabilities in this 6 yrs. old female. A diagnostic aspiration is indicated and aspirated fluid should be examined for being a transudate or exudate.

Oligoarticular JIA, trauma, ReA, ERA

JRA. Aspiration .

Acute in onset no fever no trauma no family history left side only can suspect hemolytic problem . pls do PT APTT INR if deranged go through correction studies to factor.and deficient factor can be given .

Advise Diagnostic aspiration , usg of the knee,sepsis profile .

Needs blood investigation, urine routine and aspiration of fluid and to be send to biochemistry, microbiology

Agree w dr.sanjay sir

Thanks, Abhishek.
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