A 38-Year-Old Man Comes to the Physician Because of Progressive

A 38-year-old man comes to the physician because of progressive pain and swelling of his left knee for the past 2 days. He has been taking ibuprofen for the past 2 days without improvement. Four days ago, he scraped his left knee while playing baseball. The pain starts after waking up and lasts for 20 minutes. On examination, the left knee is swollen, erythematous, warm, and tender with restricted range of active and passive motion.  The remainder of the examination is unremarkable.  Which of the following is the best next step in management of this patient?

A) Ibuprofen and follow up in 3 days
B) MRI of the knee joint
C) Radionuclide bone scan
D) Serum uric acid level
E) Synovial fluid analysis

Correct Answer:

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