Pain and swelling
The hot swollen joint (septic until aspirated, then gout or CPPD) and the painful swollen limb (DVT, cellulitis, necrotising fasciitis, compartment syndrome), with Australian antibiotic and anticoagulation choices.
Tier 1Approach to a presentation
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Two questions sort this presentation: is it a joint or the whole limb, and is it one site or many?
- An acute hot swollen joint is septic arthritis until aspirated. Crystals don't exclude infection.
- A painful swollen leg needs DVT excluded with a pretest probability score, D-dimer and whole-leg ultrasound. Cellulitis is usually unilateral; bilateral red legs are rarely infection.
Loading the rest of the note…
Finished reading?
Sources
- Therapeutic Guidelines: Rheumatology and Antibiotic (eTG complete, current online versions)AU/NZTherapeutic Guidelines Limited
- Tran HA, Gibbs H, Merriman E et al. New guidelines from the Thrombosis and Haemostasis Society of Australia and New Zealand for the diagnosis and management of venous thromboembolism. Med J Aust 2019;210(5):227-235AU/NZThrombosis and Haemostasis Society of Australia and New Zealand (Medical Journal of Australia), 2019
- FitzGerald JD, Dalbeth N, Mikuls T et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res 2020;72(6):744-760American College of Rheumatology, 2020
- Abhishek A, Tedeschi SK, Pascart T et al. The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease. Ann Rheum Dis 2023;82:1248-1257American College of Rheumatology and EULAR, 2023
- Australian guideline for the prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease (Edition 3.4, October 2026)AU/NZRHDAustralia (Menzies School of Health Research), Edition 3.4, October 2026
- Gjika E, Beaulieu JY, Vakalopoulos K et al. Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial. Ann Rheum Dis 2019;78:1114-1121Annals of the Rheumatic Diseases, 2019
- Adult sepsis empirical antibiotic guidance, including necrotising fasciitis (SW1285)AU/NZQueensland Health
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy