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Elbow Pain & Fever

UNFINISHED CASE: COME BACK LATER  Scroll to bottom for case answer and E-meducation 

History:

  • A 64-year-old male with ESRD presents with non-traumatic severe left elbow pain for one day with a low grade fever.
  • He denies any injury or other complaints.

Exam:

  • Vital signs were normal except for a temperature of 99.7.
  • Physical exam was normal except for slight redness around the elbow and very painful range of motion

Initial Concern(s):

  • Cellulitis
  • Septic Olecranon bursitis
  • DVT

Testing:

  • WBC elevated at 12.8
  • Duplex negative
  • Elbow X-ray below

QUESTIONS:

  1. What does the case image image show?  
  2. What should you do next?  
  3. Where can I get a quick refresher on this topic? 

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

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ANSWERS:

  1. What does the case image image show?  An elbow effusion
  2. What should you do next?  Tap the elbow to determine the cause.  The fluid results were as follows: WBC 46,000 with 82% PMN and positively birefringent crystals
  3. Where can I get a quick refresher on this topic?  See highlighted area below

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E-meducation for medical topic of this case: Read the yellow highlighted area of the page-shot below from our #1 title, the Emergency Medicine 1-Minute Consult Pocketbook

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CASE CONCLUSION: We’ll just have to see

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