Differential Diagnosis for a 15-year-old with URI symptoms, fever, and sore hips and legs
- Single most likely diagnosis:
- Influenza: This is a common cause of URI symptoms, fever, and myalgias (muscle pains), which could include sore hips and legs, especially in the context of a current outbreak.
- Other Likely diagnoses:
- Viral myositis: Various viruses can cause myositis, leading to muscle pain, including in the hips and legs, accompanied by fever and URI symptoms.
- Mononucleosis: Caused by Epstein-Barr virus, it can present with fever, sore throat, and myalgias, although the sore hips and legs might be less typical.
- Streptococcal pharyngitis: While primarily causing throat pain, it can be accompanied by fever and myalgias, including hip and leg pain in some cases.
- Do Not Miss diagnoses:
- Septic arthritis: Although less common, it is a serious condition that requires prompt diagnosis and treatment. Fever and hip or leg pain could be indicative of septic arthritis, especially if there's significant pain or limitation in movement of the affected joints.
- Osteomyelitis: An infection of the bone, it can cause fever, pain, and swelling in the affected area. While less likely, it's critical to consider due to its serious nature and need for early intervention.
- Lyme disease: If the patient is in an area where Lyme disease is prevalent and has been exposed to ticks, this could be a consideration, especially if there are additional symptoms like a rash.
- Rare diagnoses:
- Leukemia: Certain types of leukemia can present with bone pain, fever, and fatigue. Although rare, it's an important consideration in the differential diagnosis due to its severity and the need for early treatment.
- Rheumatic fever: A complication of untreated streptococcal infection, it can cause fever, joint pain (including hips and legs), and other symptoms. It's less common in areas with good access to healthcare but remains a critical diagnosis not to miss.