Acute crystal arthritis mimicking infection after total knee arthroplastyBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7528.1322 (Published 01 December 2005) Cite this as: BMJ 2005;331:1322
- G Holt (email@example.com), specialist registrar1,
- C Vass, senior house officer1,
- C S Kumar, consultant1
- 1Department of Orthopaedic and Trauma Surgery, Glasgow Royal Infirmary, Glasgow G4 0SF
- Correspondence to: G Holt
- Accepted 29 April 2005
Total knee arthroplasty is the most effective treatment to relieve the pain associated with end stage arthritis of the knee.1 A reported 0.5-2% of people will develop sepsis of the implant, necessitating lavage and debridement of the affected knee with immediate or delayed removal of the implant.2 3 The key to successful management of implant sepsis is early and accurate diagnosis, which allows prompt treatment. Every patient with pain and swelling at the site of a total knee arthroplasty must, therefore, be assessed for infection.1 We report a case of a patient initially diagnosed as having implant sepsis who in fact had pseudogout of the knee. This shows the diagnostic difficulties and issues surrounding management that may arise when a patient presents with crystal arthritis at the site of previous joint replacement.
A previously well 72 year old man presented with a three day history of progressive swelling of the left knee with associated pain, erythema of the skin, tachycardia, and a fever of 38.8°C. Two years before, the patient had had primary total knee arthroplasty surgery of the affected joint for a …
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