Pediatric emergency medicine trisk 2924 2924

by tenderness,
swelling, or effusion

Pleuritis or
pericarditis

Pleuritis—convincing Serositis
history or pleuritic
pain or rub heard by
a physician or
evidence of pleural
effusion or
Pericarditis—
documented by
EKG, rub, or
evidence of
pericardial effusion
on echocardiography

Renal disorder Persistent proteinuria Renal disorder
>0.5 g/day or >3% if
quantitation not
performed or
cellular casts—may
be red cell,
hemoglobin,
granular, tubular, or
mixed
Neurologic
Seizures or psychosis Neurologic
disorder

—in the absence of
disorder
offending drugs or
known metabolic
derangements
(uremia,

or more joints and
30 minutes or
more of morning
stiffness
Typical pleurisy for
more than 1 day
or pleural
effusions or
pleural rub, or
typical pericardial
pain (pain with
recumbency
improved by
sitting forward)
for more than 1
day, or pericardial
effusion, or
pericardial rub or
pericarditis by
EKG in the
absence of other
causes, such as
infection, uremia,

and Dressler’s
pericarditis
Urine protein-tocreatine ratio (or
24-hr urine
protein)
representing 500
mg protein/24 hrs
or red blood cell
casts
Seizures; psychosis;
mononeuritis
multiplex (in the
absence of other
known causes
such as primary