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A 20-year-old heterosexual man presented with a painful, swollen left knee. There were no other symptoms. His last sexual contact had involved unprotected intercourse with a casual female partner two years earlier. On examination he was afebrile, with a swollen, inflamed left knee and a vasculitic rash on his legs and arms. The white-cell count was 19.9x109 per liter; knee
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