A 54-year-old woman presents with a hot, swollen, very tender right first metatarsophalangeal joint, which became painful overnight. She is febrile at...

Question

A 54-year-old woman presents with a hot, swollen, very tender right first metatarsophalangeal joint, which became painful overnight. She is febrile at 38.0°C. There is no history of trauma. What is the most appropriate next step in management?

Accepted Answer

Urgent joint aspiration for microscopy and culture to exclude septic arthritis

Answer

Start NSAIDs for presumed gout without investigation

Answer

Arrange routine rheumatology referral without acute treatment

Answer

Prescribe antibiotics for presumed cellulitis without joint assessment

Answer

Reassure and observe without treatment

uk-plab-1 MCQ (SBA): Acute monoarthritis – septic arthritis

A 54-year-old woman presents with a hot, swollen, very tender right first metatarsophalangeal joint, which became painful overnight. She is febrile at 38.0°C. There is no history of trauma. What is the most appropriate next step in management?