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  Retired NBME Step 2 CK Free 120 Answers
  
 
 
  
  gigantichawk 
  
    "Septic arthritis may be definitively established in the setting of positive synovial fluid Gram stain/culture.  In patients with purulent synovial fluid (leukocyte count 50,000 - 150,000) but negative synovial fluid cultures, a presumptive diagnosis of septic arthritis can be made."
Acute Calcium Pyrophosphate deposition would typically have a leukocyte count of 15,000 - 30,000 on aspiration.
  
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  lilmonkey 
  
    If the Gram stain is negative but there is suspicion of bacterial arthritis, vancomycin plus either ceftazidime or an aminoglycoside is appropriate.
  
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submitted by โgigantichawk(1)
Was anyone thinking calcium pyrophosphate? Inflammatory joint, patient with RA, no organisms seen on FNA, would be treated with steroids?