Agree
honestly think this is fine as is and likely written like this purposefully to really hone in on the other symptoms in the card, card may have been written like this based on the uworld question it’s from but not sure - “Typically, a synovial fluid analysis will show a white blood cell (WBC) count of 50,000 cells/mm3 or more; although, a cell count below 10,000 cells/mm3 is not uncommon” - Gonococcal Arthritis - StatPearls - NCBI Bookshelf - would really like more opinions here bc I could still see this needing approved
Initially would’ve supported, but you make a good case - I would be inclined to leave as-is.
According to UpToDate “With most bacterial organisms, particularly Staphylococcus aureus, the synovial fluid WBC count is typically >50,000 cells/microL
However, lower counts may be observed in the setting of septic artritis, especially for disseminated gonococcal infection…”
Maybe it’s better just to add this in the extra section
I think adding into the extra section as MarioNV said would be the best option
I think the card should be changed. While it is true that gonococcal septic arthritis may present with a WBC count < 50,000, it could also present with a WBC count above 50,000. The WBC count from the synovial fluid analysis will be elevated and the information in the card does not reflect that (it just says < 50,000).
Further, there are no other symptoms included in the card to point us to gonococcal septic arthritis: no risk factors given for gonococcal infection, no skin manifestations, no tenosynovitis.
There’s not enough information in the card to differentiate between inflammatory arthritis (e.g., rheumatoid arthritis) and septic arthritis, and stating that the WBC count is < 50,000 points away from septic arthritis.