<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 50-year-old woman comes to the physician because of worsening pain and swelling of her left knee. For the past year, she has had pain in her knees and hands bilaterally, but never this severe. During this period, she has also had difficulties moving around for about an hour in the mornings and has been sweating more than usual, especially at night. She has been sexually active with a new partner for the past 4 weeks, and they use condoms inconsistently. She occasionally drinks alcohol. The day before she drank 6 beers because she was celebrating a friends birthday. Her temperature is 38.5C 101.3F, blood pressure is 11070 mm Hg, and pulse is 92min. The left knee is erythematous, swollen, and tender; movement is restricted due to pain. There is swelling of the metacarpophalangeal joints and proximal interphalangeal joints bilaterally. Arthrocentesis of the knee with synovial fluid analysis shows a greenish, turbid fluid, a cell count of 68,000 WBCμL and Gram-negative diplococci. An x-ray of the affected knee is most likely to show which of the following findings?? A: Calcifications and osteolysis with moth-eaten appearance, B: Osteophytes and subchondral cysts, C: Irregularity or fragmentation of the tubercle, D: Calcification of the meniscal and hyaline cartilage, E: Joint space narrowing and bone erosions,  <response>: This is a clinical vignette describing a 50-year-old woman with worsening pain and swelling of her left knee. She has a 1 year history of pain in her knees and hands bilaterally. She also has morning stiffness and night sweats. She has a new sexual partner and inconsistently uses condoms. She recently drank 6 beers. On exam, she has a fever, swollen and tender left knee with restricted movement, and swollen hand joints. Arthrocentesis of the knee shows turbid fluid with high WBC count and Gram-negative diplococci. The key findings here are the 1 year history of joint pain, morning stiffness, night sweats, new sexual partner, fever, swollen and tender joints, and arthrocentesis results showing inflammatory fluid with bacteria. This clinical presentation is most consistent with septic arthritis joint infection with an underlying diagnosis of rheumatoid arthritis. The x-ray findings in septic arthritis include joint space narrowing and bone erosions. The presence of Gram-negative diplococci specifically points towards gonococcal arthritis given her sexual history.E: Joint space narrowing and bone erosions 