Man has severe knee pain, swelling, despite no injury – Let’s diagnose

A 65-year-old man presented to the doctor with complaints of severe knee pain, decreased range of motion, and a painful skin lesion that developed on his left knee over the past week. On examination, the patient had a temperature of 100.6°F (38.1°C). There was a swollen, erythematous, ulcerated lesion that felt tender and warm to palpation over his left knee. The patient had a 15-year history of rheumatoid arthritis. His social history included more than 20 years of smoking 10+ cigarettes daily. Plain film x-ray showed joint effusion, and MRI showed increased signal and fluid within the joint. The patient had no known history of recent trauma and appeared well.

What’s the diagnosis?

  1. Gout
  2. Knee septic arthritis
  3. Osteoarthritis of knee
  4. Prepatellar bursitis

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