You have a patient with bilateral knee and ankle joint pain and subcutaneous nodules over the extensor surfaces. Which of the following additional criteria is needed to confirm the diagnosis of acute rheumatic fever (ARF)?

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In a patient with bilateral knee and ankle joint pain and subcutaneous nodules over the extensor surfaces, the additional criteria that is needed to confirm the diagnosis of acute rheumatic fever (ARF) is evidence of preceding streptococcal infection. This patient has two major Jones' criteria for ARF. To make the diagnosis, evidence of streptococcal antibodies is needed. Major Jones' criteria include carditis, polyarthritis, erythema marginatum, chorea, and subcutaneous nodules.

You Have a Patient with Bilateral Knee and Ankle Joint