06-03-2017, 08:42 AM
A previously healthy 4-year-old girl is brought to the physician because of fever and refusal to walk for 1 day. She appears mildly ill. Her temperature is 38.6 C (101.5 F), pulse is 120/min, and respirations are 22/min. The right knee is erythematous and swollen. She holds her right knee in flexion and resists any attempted movement of her right leg. She cries when the right knee is moved. Which of the following is the most appropriate next step in management?
A) Acetaminophen with codeine therapy
B) Arthrocentesis
C) Bone marrow aspiration
D) Bone scan
E) Immobilization and traction
F) Lyme titer
G) MRI of the spine
H) Physical therapy
I) Reassurance
J) Serum rheumatoid factor assay
K) Systemic antibiotic therapy
A) Acetaminophen with codeine therapy
B) Arthrocentesis
C) Bone marrow aspiration
D) Bone scan
E) Immobilization and traction
F) Lyme titer
G) MRI of the spine
H) Physical therapy
I) Reassurance
J) Serum rheumatoid factor assay
K) Systemic antibiotic therapy