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Orthopaedics · Knee trauma: septic arthritis
Sample itemA child has fever, refuses to bear weight, and has a hot painful swollen knee with restricted passive motion. What is the priority?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Urgent evaluation for septic arthritis and joint drainage if confirmed
Septic arthritis can rapidly destroy cartilage and cause sepsis. Urgent aspiration, microbiology, antimicrobial treatment, and orthopedic drainage when indicated are required.
Option by option
A. Treat as a minor sprain
A simple sprain should not cause fever and painful passive restriction.
B. Start physiotherapy only
Physiotherapy cannot treat joint sepsis.
C. Wait for symptoms to settle over a week
Delay risks irreversible cartilage damage.
D. Urgent evaluation for septic arthritis and joint drainage if confirmed (correct)
Correct. A hot non-weight-bearing joint with fever is an orthopedic emergency.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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