Rheumatology: septic arthritis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Rheumatology: septic arthritis

Sample item

A 55-year-old has an acutely hot, swollen, painful knee with fever. What is the best next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Joint aspiration for cell count, Gram stain and culture, then intravenous antibiotics

A single acute hot joint with fever is septic arthritis until proven otherwise, and Staphylococcus aureus is the commonest organism. Synovial aspiration with culture should be done before antibiotics, which are then started promptly with drainage as needed. Delay destroys cartilage.

Option by option

  • A. Start NSAIDs and review in a week

    Waiting a week risks rapid joint destruction.

  • B. MRI before any treatment

    Imaging should not delay aspiration and antibiotics.

  • C. Intra-articular corticosteroid injection

    Steroid injection into an infected joint is dangerous.

  • D. Joint aspiration for cell count, Gram stain and culture, then intravenous antibiotics (correct)

    Correct. Aspirate, then treat with intravenous antibiotics without delay.

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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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Joint aspiration for cell count, Gram stain and culture, then intravenous antibiotics. A single acute hot joint with fever is septic arthritis until proven otherwise, and Staphylococcus aureus is the commonest organism.

Why is "Start NSAIDs and review in a week" not the answer?

Waiting a week risks rapid joint destruction.

Why is "MRI before any treatment" not the answer?

Imaging should not delay aspiration and antibiotics.

Why is "Intra-articular corticosteroid injection" not the answer?

Steroid injection into an infected joint is dangerous.

What concept does this question test?

It tests Rheumatology: septic arthritis in General Medicine. Synovial aspiration with culture should be done before antibiotics, which are then started promptly with drainage as needed. Delay destroys cartilage.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Rheumatology: septic arthritis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.