Pediatric emergency medicine trisk 1158 1158

Figure 60.1 depicts an algorithm for the diagnostic approach to the child with
joint pain. The evaluation should include inquiries about the specific joint(s)
involved, symptom duration, and history of trauma, fever, rash, tick bites, sexual
risk factors, intravenous drug use, and recent illnesses. The child’s past medical
and family histories should be reviewed. A family history of systemic lupus
erythematosus (SLE), inflammatory bowel disease, or rheumatoid arthritis
increases the child’s risk for autoimmune-related diseases.
A comprehensive physical examination should be performed with particular
attention paid to a search for rashes, heart murmurs, and abdominal abnormalities.
Assessment of the affected joint(s) should determine if it is warm, swollen, or
tender as well as its range of motion.