A 2-Year-Old Boy Is Brought to the Emergency Department Due

A 2-year-old boy is brought to the emergency department due to high fever and malaise for the past 4 days.  His parents say that he began limping yesterday and now refuses to walk.  The patient has had no recent travel or exposure to anyone with similar symptoms.  Temperature is 39.4 C (103 F) .  Passive range of motion of the hips, knees, and ankles does not elicit pain.  There are no joint effusions.  The patient refuses to bear weight.  An intravenous radiotracer that localizes to areas of increased osteoblastic activity is administered, and several images are obtained to find areas with atypical activity.  Abnormally increased uptake of the radiotracer is most likely to be seen in which of the following areas?

A) Flat bone
B) Long bone diaphysis
C) Long bone epiphysis
D) Long bone metaphysis
E) Vertebral body

Correct Answer:

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