An unusual cause of acute polyarticular arthritis.

摘要

A 7-year-old otherwise healthy Caucasian male presented to an outside hospital with a chief complaint of joint pain. The patient had a 3-day history of cough and rhinorrhea but had otherwise been in his usual state of health until he woke with right shoulder pain on the morning of admission. The shoulder pain progressively worsened throughout the day, and he subsequently developed severe left ankle pain and swelling. By the time the patient was evaluated at the outside hospital, he had developed a temperature of 102(deg)F, was unable to ambulate, and had limited range of motion secondary to pain. There he received chest, right shoulder, and left ankle radiographs, a complete blood count, and blood culture. He was treated for pain and transferred to Cardinal Glennon Children's Medical Center for further evaluation.