There are many questions concerning knee effusions and the basic diagnostic approach to them. The case of a young female with gonococcal arthritis presenting to the Emergency Room with an isolated knee effusion is discussed. From the errors in diagnosis of this case, a basic outline in the approach and work-up of a knee effusion is detailed, including history and physical examination, and the use of synovial fluid analysis as a further diagnostic aid. Procedural instructions and contraindications for knee arthrocentesis are given, as well as data related to interpretation of pertinent laboratory findings of synovial fluid in disease states.
关于膝关节积液及其基本诊断方法存在许多问题。本文讨论了一名患有淋菌性关节炎的年轻女性因单纯膝关节积液就诊于急诊室的病例。从该病例的诊断失误中,详细阐述了膝关节积液的诊断方法和检查流程的基本要点,包括病史和体格检查,以及将滑膜液分析作为进一步诊断辅助手段的应用。文中给出了膝关节穿刺术的操作说明和禁忌证,以及与疾病状态下滑膜液相关实验室检查结果解读有关的数据。