Septic arthritis and transient synovitis (pediatrics) Quiz: Ace Your Exams
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A 3-year-old boy is brought by his parents to the emergency department for evaluation of right leg pain. The patient had multiple episodes of watery diarrhea and low-grade fevers five days ago, which have fully resolved. However, over the past two days, the patient began complaining of right leg pain, and today he was limping. The patient has no significant past medical history and does not take any medication. Parents deny dysuria or hematuria. He is up-to-date on his vaccinations. Temperature is 37.9°C (100.2°F), blood pressure is 95/58 mmHg, pulse is 135/min, respiratory rate is 20/min, and oxygen saturation is 97% on room air. On physical examination, the patient is in no acute distress and is well-appearing. There is limited range of motion at the right hip secondary to pain, but active and passive movement is possible. There is no obvious erythema or warmth over the hip. All other joints are within normal limits. Laboratory results are shown below. Hip ultrasound shows an effusion. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 12.5 g/dL |
| Leukocyte count | 16,100/mm3 |
| Platelet count | 344,000/mm3 |
| C-reactive protein (CRP) | 1mg/dL |
| Erythrocyte sedimentation rate (ESR) | 15 mm/h |
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