A 60-year-old male presents with a swollen, hot, erythematous knee. He is febrile at 38.5°C. He has no history of trauma. He takes methotrexate for rh...

Question

A 60-year-old male presents with a swollen, hot, erythematous knee. He is febrile at 38.5°C. He has no history of trauma. He takes methotrexate for rheumatoid arthritis. What is the most important diagnosis to exclude?

Accepted Answer

Septic arthritis - immunosuppression from methotrexate increases risk; this is a surgical emergency requiring urgent joint aspiration

Answer

Haemarthrosis - spontaneous bleeding into the joint

Answer

Osteoarthritis flare - the most common cause of a hot joint

Answer

Gout - the most likely diagnosis in this age group

Answer

Reactive arthritis - likely viral trigger

uk-dipimc MCQ (SBA): Septic Arthritis

A 60-year-old male presents with a swollen, hot, erythematous knee. He is febrile at 38.5°C. He has no history of trauma. He takes methotrexate for rheumatoid arthritis. What is the most important diagnosis to exclude?