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Case: 5 year old girl with fever and leg pain | |
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A 5 year old girl was brought to a doctor because of left leg pain and on and off fever for six days. Five days before, she was brought to an emergency room because of one day fever (102.9 F; 39.3 C) and pain at the left knee and thigh. She did not have any history of injury. Otherwise she is healthy. A blood count and ESR (erythrocyte sedimentation rate) were normal. She was diagnosed with “toxic synovitis.” Two days later, she was brought again to the emergency because of worsening left leg pain. A repeat ESR was now elevated to 37 mm/hour. Today she woke up with a fever of 105 F (40.5 C) with more pain at the leg. Complete flexion, extension, or rotation of her left hip is not possible because of pain. There is limited extension of her left leg. There was no swelling or redness in the left leg and the rest of the physical examination was normal.
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