A (b)(6) male with pmh significant for osteoarthritis received hylan g-f (synvisc) 48mg/6ml injection in both knees on (b)(6) 2013.Patient contacted primary care clinic (b)(6) 2013 with complaints of right knee pain and swelling post injection.Patient was seen by rheumatologist who performed injections and right knee arthrocentesis completed.12cc of fluid removed from right knee.Patient instructed to continue naproxen for pain/ inflammation and return to clinic 3 days later for f/u.Patient reported to ed over the weekend, (b)(6) 2013, with recurrent swelling and pain.Arthrocentesis completed in ed produced-100cc of fluid.Patient was sent home from ed with prn oxycodone/apap.F/u with rheumatologist (b)(6) 2013, showed continued swelling of knee joint.Naproxen stopped and etodolac started.F/u with rheumatologist (b)(6) 2013 states improvement in knee swelling but continued knee pain despite trail of multiple nsaids.Patient was referred to orthopedics for further treatments options.Scheduled for ortho f/u (b)(6) 2013.Symptoms: pseudoseptic reactions; suspect during # 1 dosing: inject the contents of one syringe (48 mg) intra - articularly once for procedure to affected knee(s) to reduce pain.
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