A number of things could be causing Sally's problems. Just a few of these would include lyme disease, SLE, septic arthritis, rheumatoid arthritis, traumatic arthritis, acute rheumatic fever, and congenital heart disease. Did you look at Sally's previous illnesses? Travel history could be important. Presence of any skin rashes. If so, what types of rashes. Any previous drug use (e.g. current and past meds).
