RT Journal
A1 Adderson EE, Shultz PK, Bohnsack JF
T1 RAdiological case of the month
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 1999
FD September 1
VO 153
IS 9
SP 995
OP 995
DO 
UL http://dx.doi.org/
AB 
A 14-YEAR-OLD GIRL was referred for evaluation of a fever of unknown origin. She was in good health until 2 months previously, when she abruptly developed an elevated temperature and back pain. A urine culture was sterile. She had an elevated white blood cell count and a Westergren erythrocyte sedimentation rate of 116 mm/h. A chest radiograph and abdominal ultrasound were normal. Sinus radiographs indicated sinusitis. She was treated with azithromycin without improvement. A radionuclide bone scan demonstrated increased tracer uptake in the calvarium, left ninth rib posteriorly, and both knees. Results from radiographs of the skull and knees were normal. Serum antinuclear antibodies were positive with a level of 1:80. Several blood and urine cultures were sterile. Results of a serologic study for Epstein-Barr virus suggested a distant infection. A cytomegalovirus serologic study was negative.