A (b)(6) yo female with known osteoarthritis of the knees, xray and clinical exam.Poorly tolerant of nsaids.We agreed on a series of synvisc injections for the left knee, which were done on (b)(6) 1999.Each injection seemed technically satisfactory, with the synvisc being injected within the joint space.On (b)(6) 1999, the patient developed severe left knee pain.She was seen on (b)(6) 1999, and there appeared to be mild warmth and swelling.C - reactive protein was 2.8, (normal < 1.4).No fever, a diagnostic left knee aspiration was performed; no fluid was obtained (dry tap).She was treated with choline mg salicylate.She was re-examined on (b)(6) 1999, and the knee was significantly better (back towards baseline), without effusion.I believe pt had a reaction to the synvisc, without infection (she received no antibiotics), although i can't rule out the possibility of a crystalline arthritis (e.G., pseudogout) triggered by the injections.
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