A 16-year-old boy is seen in the emergency department with abdominal pain and fever. His right knee is also exquisitely tender and slightly swollen. He has suffered recurrent attacks with a similar presentation since childhood, although normally they are more severe and also include pleurisy. He has been told that ‘it runs in the family. The attacks resolve spontaneously and in between times he is entirely well. Examination This adolescent is very uncomfortable, with a temperature of 38.8°C.
His pulse rate is 110/min, blood pressure 115/63 mmHg. He has marked abdominal tenderness with rebound and guarding; his bowel sounds are reduced. There is a mild and cool effusion of his right knee, which is extremely tender. The rest of his examination is normal. What diagnosis might explain the recurrent abdominal pain, pleurisy and fever? * This case is from Docplexus editorial team for…
