Rosh Pediatrics Practice Exam

What major criterion can be associated with a diagnosis of rheumatic fever in a patient with fever and joint pain?

1. Fever

2. Joint pain

3. Rash

4. Recent sore throat

The correct answer is: Rash

In considering the diagnosis of rheumatic fever, the presence of a recent sore throat is a major criterion that is often linked to the condition. Rheumatic fever is a complication that can arise after an infection with group A Streptococcus, which commonly causes pharyngitis or strep throat. For diagnosis, the occurrence of a recent sore throat serves as a critical clinical marker indicating that the rheumatic fever may have developed following such an infection. In the context of this diagnosis, the presence of fever, joint pain, and rash are associated findings, but they are classified as minor criteria. While fever and joint pain are certainly important symptoms that can lead to the suspicion of rheumatic fever, they do not independently confirm its diagnosis. Instead, the history of a recent sore throat specifically provides the link to the preceding streptococcal infection, thereby fulfilling a major diagnostic criterion.