A 5-year-old girl represents to your emergency department. She was seen last week for a limp and diagnosed with transient synovitis. She has continued to complain of knee pain and this morning seems more unwell with a fever and lethargy.
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1. Question
What is your initial approach to management?
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2. Question
An hour later the patient’s blood results are returned:
Haemoglobin (g/L)
70 (115-165)
Mean Cell Volume (fl)
105 (80-100)
Platelets (109/L)
60 (150-400)
White cell count (109/L)
2 (4-11)
CRP mg/L
20 (0-5)
In addition to septic arthritis or osteomyelitis, what other diagnoses should you consider at this point and what further blood tests are required?