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The spectrum of group A streptococcal joint pathology in the acute care setting.
[acute rheumatic fever]
Group
A
streptococcus
(
GAS
)
is
a
frequent
cause
of
pediatric
musculoskeletal
infections
including
septic
arthritis
,
acute
rheumatic
fever
(
ARF
)
,
and
a
more
benign
arthritis
called
post-streptococcal
reactive
arthritis
.
Children
with
painful
joints
are
frequently
evaluated
in
the
acute
care
setting
,
and
because
the
presentation
of
each
of
these
entities
is
similar
,
the
diagnosis
can
be
difficult
to
make
.
Five
cases
of
children
with
GAS
arthridities
are
presented
to
demonstrate
the
spectrum
of
GAS
-associated
joint
pathologies
encountered
in
the
acute
care
setting
and
also
to
discuss
how
GAS
laboratory
tests
may
assist
in
the
evaluation
and
management
of
children
presenting
with
a
painful
joint
.
Five
cases
of
GAS
-associated
joint
pathology
are
presented
.
Evaluation
of
these
patients
was
conducted
using
a
diagnostic
algorithm
derived
from
a
literature
review
of
post-streptococcal
reactive
arthritis
and
ARF
,
as
well
as
the
current
clinical
practice
guideline
for
the
diagnosis
and
treatment
of
septic
arthritis
.
The
5
cases
presented
include
1
case
of
transient
synovitis
,
2
cases
of
inflammatory
synovitis
,
1
case
of
septic
arthritis
,
and
1
case
of
ARF
.
D
etermining
the
cause
of
joint
pain
in
the
acute
care
setting
is
challenging
.
The
addition
of
the
GAS
laboratory
tests
to
a
diagnostic
algorithm
based
on
clinical
examination
and
monitoring
systemic
inflammation
can
help
to
identify
patients
with
ARF
and
septic
arthritis
in
the
acute
care
setting
.
In
addition
,
GAS
-
specific
laboratory
tests
may
help
to
identify
cases
of
nonseptic
,
non-
ARF
GAS
joint
pathology
.
Diseases
Validation
Diseases presenting
"transient synovitis"
symptom
acute rheumatic fever
pyomyositis
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