Presentation
Acute presentation with a swollen right knee, warm and painful to touch, the patient unable to weight bear. CRP is 120? infection.
Patient Data
Large knee joint effusion. Severe degenerative change in the patellofemoral joint. Mild medial and lateral compartment degeneration with faint chondrocalcinosis. No specific features of infection although radiography is insensitive to this.
Marked patellofemoral degeneration in comparison to the tibiofemoral compartments raises the possibility of CPPD for joint fluid analysis.
Case Discussion
The joint was aspirated and the fluid was sent for analysis which demonstrated pyrophosphate crystals on examination under polarised light.