A 15-year-old girl presents to the emergency department with complaints of bilateral thigh and hip pain. The pain has been present for 1 day and is steadily increasing in severity. Acetaminophen and ibuprofen have not relieved her symptoms. She denies any recent trauma or excessive exercise. She reports feeling fatigued and has been having burning with urination along with uri
nary frequency. She reports having similar pain episodes in the past, sometimes requiring hospitalization. On examination, she is afebrile and in
no acute distress. No one in her family has similar episodes. conjunctiva and mucosal membranes are slightly pale . She has nonspecific bilateral
anterior thigh pain with no abnormalities appreciated. The remainder of her examination is normal. Her WBC count is elevated at 17,000/mm3, and her HB level is decreased at 7.1 g/dL. Urinalysis demonstrated an abnormal number of numerous bacteria.
What is the most likely diagnosis?
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