Teleconference 17/6/04

Bill, 54 year old man

Truck driver, married, 2 children

Presents with 24 hours increasingly painful and swollen L knee

No Hx trauma

Other jts OK

Never before

No Hx gout

No fevers

T 37.3

Knee effusion, warm and tender++ generally, reduced ROM++ from pain

Explore other history features – CVD risks, sexual activity for gono, Reiters, medications

Examination

DDx of monoarticular arthritis

Ix including aspiration (who has done, which joints, what to do with the fluid)

Mx – when to admit, how to manage

Jenny, 33 yo student

Three weeks history swelling and stiffness and pain in her hands, partic in the morning

No Fhx

Generally well though tired recently

Examination

Afebrile

Synovitis in MCP joints, tenderness