Knee Arthrocentesis in Adults

Arthrocentesis of the knee is a procedure in which a needle is inserted into the knee joint, and synovial fluid is aspirated. An arthrocentesis can be ...

BronxCare Health System

Colchicine has been used in conditions such as periodic febrile illness, acute pericarditis, and gouty arthritis, all having a common hyperinflammatory response as seen in moderate to severe forms of coronavirus disease 2019 (COVID-19). This project was carried out during the rapid surge of cases in New York City, and the goal was to assess the efficacy of colchicine in treating patients with COVID-19.

A Case Control Study to Evaluate the Impact of Colchicine on Patients Admitted to the Hospital with Moderate to Severe COVID-19 Infection.

Sjögren's syndrome is an autoimmune disease characterized primarily by decreased exocrine gland function leading to eye and mouth dryness. Extraglandular manifestations occur less frequently. . A 74-year-old man with hypertension was admitted with productive cough and fever. On physical examination, he had bilateral lower lung decreased breath sounds. A chest radiograph showed bibasilar patchy infiltrate. Laboratory studies revealed hemoglobin of 11.9 g/dL, white blood cell count of 16,000/uL, and platelet count of 250,000/uL. Empiric antibiotic therapy was begun for suspected community acquired pneumonia, and then he was discharged home. However, his cough recurred. Chest computed tomography demonstrated adenopathy throughout the mediastinum and multiple ill-defined patchy groundglass opacities with a lower lobe prominence. He underwent a transbronchial biopsy to rule out malignancy; however, it showed lymphocytic interstitial pneumonitis. Antinuclear antibody was 1 : 80 homogeneous, and anti-SSA antibody was 6.3 AI (normal <1.0 AI). The patient was treated with prednisone 20 mg/day with marked improvement in his symptoms. Repeat chest computed tomography showed decreased groundglass opacities and decreased mediastinal lymph nodes. After more than a year, he was readmitted due to petechiae on his buccal mucosa and a platelet count of 2000/L. The patient was started on prednisone 80 mg/d and intravenous immunoglobulin 80 g/d for 2 consecutive days. The platelet count eventually increased to 244,000/L.

Atypical Sjögren's Syndrome Initially Presenting as Lymphocytic Interstitial Pneumonitis followed by Immune Thrombocytopenia.

A common causative organism in osteomyelitis in sickle cell disease is . Septic arthritis and muscle infection due to  are much less common. We present a case of a 28-year-old woman with sickle cell disease who presented with left shoulder and elbow pain for two days. Physical examination revealed swelling of the left upper arm. The patient was initially treated for a sickle cell pain crisis. On hospital day 4, the patient developed a fever. She empirically started intravenous vancomycin and cefepime before her blood culture showed . Subsequently, the antibiotic was changed to ceftriaxone. Synovial fluid analysis of the left shoulder revealed a white blood cell count of 53,250/mm with mostly neutrophils, and this led to a presumptive diagnosis of septic arthritis. She underwent a left shoulder arthroscopic irrigation and debridement. The synovial fluid culture was negative. Magnetic resonance imaging (MRI) revealed osteomyelitis in the left humerus, a 4.4 x 5 cm intramuscular abscess near the distal anterior humerus, and pyomyositis. Percutaneous abscess drainage was done. The patient was discharged home on ceftriaxone but returned 12 days later with worsening pain in her shoulder. Repeat MRI showed a complex glenohumeral joint effusion. She had an incision and drainage of her left shoulder. The patient was discharged on an eight-week course of ceftriaxone. Prompt diagnosis and early treatment are essential in reducing the mortality and morbidity associated with these joint, bone, and muscle infections.

Arlene Tieng

Department of Medicine

BronxCare Health System

Knee Arthrocentesis in Adults

Arlene Tieng

.css-o250i3{font-size:18px;font-family:Open Sans,sans-serif;line-height:21.6px;}Department of Medicine

BronxCare Health System

Knee Arthrocentesis in Adults

Department of Medicine