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Comment & Response
November 2015

Appropriate Care of a Swollen Joint

Author Affiliations
  • 1Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
JAMA Intern Med. 2015;175(11):1866. doi:10.1001/jamainternmed.2015.5068

To the Editor After the opportunity to review the article titled “Failure to Cancel Tests: A Case of an Unnecessary Joint Arthrocentesis: A Teachable Moment”1 with my journal club, I believe there are a number of points to take issue with and would offer the following observations:

With this information, the resident was correct to order the films, but the resident should have also obtained an arthrocentesis that night with ultrasound-guided aspiration by rheumatology, orthopedics, or interventional radiology. Waiting until Tuesday—5 days after initially presenting to the emergency department according to the article1—for an evaluation is not ideal, so perhaps the article should have been titled “Better Late Than Never.”

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