Polyarthritis Table I13

3. Osgood-Schlatter disease. Most common presentation is a boy in early adolescence with point tenderness or swelling at either (or both) tibial tubercle(s).

4. SCFE. Commonly presents as an afebrile obese boy in early adolescence with knee, thigh, or hip pain without arthritis; restricted range of motion, with or without preceding minor trauma.

TABLE I—13. POLYARTHRITIS AND ASSOCIATED FINDINGS

Etiology

Associated Findings

Acute rheumatic fever (ARF)

Disseminated gonococcal infection Henoch-Schonlein purpura (HSP) Juvenile rheumatoid arthritis (JRA) Kawasaki disease Lyme disease

Postinfectious

Serum sickness

Systemic lupus erythematosus (SLE)

Painful arthritis, new murmur or congestive heart failure, recent group A streptococcal infection Fever, vesicular or pustular rash, tenosynovitis Purpuric rash below waist Chronic or recurrent fever and rash See discussion under Differential Diagnosis, earlier Polyarthralgia or polyarthritis in early stages, recent tick bite, fever, malaise

Onset 1-2 weeks after gastroenteritis, often involving large, lower extremity joints Urticaria, angioedema, recent febrile illness or antibiotic use

Highly variable, may include skin or renal involvement

5. LCPD. Commonly presents as a boy, aged 4-9 years, who has hip pain without arthritis but with a limp or leg-length discrepancy.

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