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Pediatrics
A child has a 2-week history of spiking fevers, which have been as high as 40degC (104degF). She has spindle-shaped swelling of finger joints and complains of upper sternal pain. When she has fever, the parents note a faint salmon-colored rash that resolves with the resolution of the fever. She has had no conjunctivitis or mucositis, but her heart sounds are muffled and she has increased pulsus paradoxus. Which of the following is the most likely diagnosis?
Rheumatic fever
Juvenile idiopathic arthritis
Toxic synovitis
Septic arthritis
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