A 15-year-old white girl was examined because of a six-day history of pain in the right medial ankle which was sharp in nature with subsequent swelling and increased heat in the affected joint. The pain remained localized to the right ankle and was persistent. The pain also radiated up the medial aspect of the right leg when she attempted to walk. Temperature elevations were 99-100 F. There were no other myalgias or arthralgias. Medications at home included aspirin and codeine without relief. The patient reported having had a sore throat about two weeks prior to admission which lasted for several days and resolved without therapy.

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