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The diagnosis and necessary intervention is obvious based on theplain films obtained. The patient had palpable crepitus to his rightmedial knee which was confirmed by the hypodensities seen on hisx rays. What made this an interesting case was the difficultysecuring the patients disposition.Within five minutes of this patient arriving the emergency department(ED), a surgical consult was placed and the patient was started onbroad spectrum antibiotics. Within fifteen minutes a general surgeonwas at the bedside. After reviewing the information, reported that theconsult should go to the orthopedics team because the infection wasisolated to the patients extremity. Within 20 minutes, Orthopedicsarrived bedside and agreed that the case was concerning for a gasproducing infection of the patients leg. The orthopedics teamattempted to calculate a LRINEC score with the initial set of resultedlabs excluding a CRP. The LRINEC score at that time suggested thepatient was low risk for necrotizing fasciitis. This score (thoughincomplete) and stable vitals reassured the orthopedics team thatthe patient did not need to be taken immediately to the OR and couldwait for a CT scan of the patients leg. As the emergency medicineteam, we advocated to take the patient emergently to the operatingroom, feeling the patient would likely decompensate if source controlwas not quickly obtained.