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Progressive unilateral arm weakness in a 7-year-old boy.

A child with joint or extremity pain is a common presentation to the emergency department. Often, there is some element to the patient's history, whether it is trauma or some other significant history, which leads to a likely diagnosis. When there is a history of fever and progressive arm weakness, an astute emergency physician would have heightened awareness of a possible systemic process. We describe a case of unilateral shoulder pain with associated fever in a 7-year-old boy who presented to the emergency department with progressive arm weakness to the same side.