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Dr. Laura Chapman (Pediatrics): A 9-year-old boy with autism was admitted to this hospital because of pain in the hip, refusal to walk, and the recent onset of a rash and gingival swelling.
The patient was in his usual state of health until approximately 3 months before admission, when he had an upper respiratory illness with fever; shortly thereafter, he began to have right hip pain, to limp, and to have decreased energy. During the next several weeks, he began to have difficulty climbing stairs, became increasingly irritable, and began moaning in his sleep at night; his appetite decreased, and
Differential Diagnosis
Chronic Recurrent Multifocal Osteomyelitis
Rheumatologic Diseases
Conditions with Altered Intestinal Permeability
Scurvy
Clinical Diagnosis
Dr. Christopher P. Duggan's Diagnosis
Pathological Discussion
Pathological Diagnosis
Source Information
From the Department of Medicine, Division of Gastroenterology and Nutrition, Children's Hospital (C.P.D.); the Departments of Radiology (S.J.W.) and Pathology (A.E.R.), Massachusetts General Hospital; and the Departments of Pediatrics (C.P.D.), Radiology (S.J.W.), and Pathology (A.E.R.), Harvard Medical School — all in Boston.
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