The case:

40-year-old man presented to the Emergency Department with a laceration after an iron bed frame fell on his knee 1 day prior. On exam, the patient had a horizontal 4-5 cm laceration on the anterior-medial aspect of his right knee with significant swelling and erythema around the joint. The wound appeared dirty, with purulent, foul smelling discharge and the knee was warm to palpation. Range of motion was limited due to pain. Radiographs were negative. Considering the overlying laceration and evidence of septic arthritis, antibiotics were administered, a CT was ordered, and the Orthopedics service was consulted. CT demonstrated no air within the joint, but the patient was taken the operating room for surgical I&D of his knee. Traumatic arthrotomy was confirmed intraoperatively.