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Four days ago a 7-year-old boy injured his left leg falling out of a tree. During the past two days he has been generally 'off colour' and has had a painful left leg. Apart from uncomplicated minor childhood illnesses, he had been previously healthy. The only positive findings on examination are a temperature of 38.4°C, slight swelling and moderate tenderness localised over the medial aspect of his left tibia 4cm below his knee, a few bruises over both shins, and a soft systolic cardiac murmur. Which one of the following is the most likely diagnosis?
(A) Acute rheumatic fever
(B) Acute leukaemia
(C) Greenstick fracture
(D) Osteomyelitis
(E) Anaphylactoid purpura
Four days ago a 7-year-old boy injured his left leg falling out of a tree. During the past two days he has been generally 'off colour' and has had a painful left leg. Apart from uncomplicated minor childhood illnesses, he had been previously healthy. The only positive findings on examination are a temperature of 38.4°C, slight swelling and moderate tenderness localised over the medial aspect of his left tibia 4cm below his knee, a few bruises over both shins, and a soft systolic cardiac murmur. Which one of the following is the most likely diagnosis?
(A) Acute rheumatic fever
(B) Acute leukaemia
(C) Greenstick fracture
(D) Osteomyelitis
(E) Anaphylactoid purpura
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