#february2020mccqe1
A 56-year-old woman with an eight year history of rheumatoid arthritis (RA) is admitted to the orthopaedic service with a hot swollen left elbow. She is taking oral methotrexate and subcutaneous etanercept for her RA. She has been well and enjoyed some gardening recently. On examination her left elbow has a flexion deformity at 150 degrees, is swollen, warm and very tender. There is some mild synovitis in her hands and wrists.
Temperature: 37.5 C. Haemoglobin: 108 g/L. White cell count: 9.8 x109g/L. Platelets: 249 x109g/L. CRP: 20 mg/L.
Which one of the following is the most likely diagnosis?
A. Acute gout
B. Acute pseudo gout
C. Cellulitis
D. Flare of rheumatoid arthritis
E. Septic arthritis
A 56-year-old woman with an eight year history of rheumatoid arthritis (RA) is admitted to the orthopaedic service with a hot swollen left elbow. She is taking oral methotrexate and subcutaneous etanercept for her RA. She has been well and enjoyed some gardening recently. On examination her left elbow has a flexion deformity at 150 degrees, is swollen, warm and very tender. There is some mild synovitis in her hands and wrists.
Temperature: 37.5 C. Haemoglobin: 108 g/L. White cell count: 9.8 x109g/L. Platelets: 249 x109g/L. CRP: 20 mg/L.
Which one of the following is the most likely diagnosis?
A. Acute gout
B. Acute pseudo gout
C. Cellulitis
D. Flare of rheumatoid arthritis
E. Septic arthritis
