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Differential Diagnosis for Polyarthralgia in a 14-year-old

Single Most Likely Diagnosis

  • Juvenile Idiopathic Arthritis (JIA): This is the most common chronic rheumatic disease in children, characterized by joint inflammation and stiffness. The age of the patient and the presentation of polyarthralgia make JIA a highly probable diagnosis.

Other Likely Diagnoses

  • Viral Infections (e.g., Parvovirus, Epstein-Barr Virus): Viral infections can cause polyarthralgia in adolescents. These infections are common in this age group and can present with joint pain among other symptoms.
  • Lyme Disease: If the patient lives in an area where Lyme disease is prevalent, this diagnosis should be considered, especially if there's a history of tick exposure. Lyme disease can cause arthritis and polyarthralgia.
  • Growing Pains: Although more common in younger children, growing pains can occasionally present in early adolescence and may cause polyarthralgia.

Do Not Miss Diagnoses

  • Septic Arthritis: Although less likely, septic arthritis is a medical emergency that requires prompt diagnosis and treatment to prevent joint destruction and other complications. It typically presents with acute onset of pain, swelling, and decreased range of motion in a single joint, but can be polyarticular.
  • Lupus: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can present with polyarthralgia among other systemic symptoms. It's crucial to consider lupus due to its potential for serious complications if left untreated.
  • Cancer (e.g., Leukemia, Lymphoma): Malignancies can cause bone and joint pain, including polyarthralgia. Although rare, these conditions are critical to diagnose early.

Rare Diagnoses

  • Rheumatic Fever: Following a group A streptococcal infection, rheumatic fever can occur and cause polyarthralgia. It's less common in areas with good access to healthcare but should be considered, especially if there's a recent history of streptococcal pharyngitis.
  • Sarcoidosis: A systemic disease that can cause polyarthralgia, among other symptoms. It's rare in children but can occur.
  • Hypermobile Ehlers-Danlos Syndrome: A genetic disorder that can cause joint hypermobility and pain, potentially presenting as polyarthralgia.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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