Responses : 2/F with knee joint effusion and rice bodies

Thank you so much for your responses 🙂

*1. Here are the responses as follows: *

TB or inflammatory arthropathy, probably not TSGCT (too young)
TB/other infectious arthritis or JIA >> synovial chondromatosis or TSGCT
(unusual at this age)

TB >> fungal infection, much less likely
TB with rice bodies
TB is a thought, also Lyme disease, juvenile arthritis.
TB and JCA

Juvenile idiopathic arthritis(JIA) or synovial chondromatosis – DDx. TB or
MAI, less likely

RA, first. DDx. juvenile idiopathic arthritis and synovial chondromatosis.

PVNS or some synovial variant.

*2. Would you go for a biopsy if the first attempt of sedation with Pocral
failed? *

1) Yes, synovial biopsy under US with 14-16G needle
2) Try aspiration first –> no fluid aspirated, then US-guided biopsy
(immediate sub-capsular synovium) Will need general sedation.
3) aspiration first

4) First, nice lab work-up on rheumatologic diseases, if not useful, would
do a synovial biopsy.
5) complete work-up of pediatric monoarthritis first, then possibly simple
joint aspiration

6) synovectomy (open/arthroscopic) for single general anesthesia