13th March 2024

A 15-year-old girl is referred to the acute medical unit with involuntary jerky movements and worsening clumsiness over the last few months.

A 15-year-old girl is referred to the acute medical unit with involuntary jerky movements and worsening clumsiness over the last few months. She is usually fit and well, although her mother does recall her suffering from a particularly unpleasant sore throat episode approximately six months prior to the onset of these unusual movements. She is currently febrile at 38.4 degrees C.

On examination you note several painless nodules over the extensor aspects of her knees and elbows. You suspect a diagnosis of rheumatic fever.

As per the Jones criteria, which of the following are regarded as major criteria for the diagnosis of rheumatic fever?

Select the SINGLE most appropriate option from the list below. Select ONE option only.