A 12-year-old patient who is being evaluated for hip pain of several weeks' duration has other complaints that are more acute. The patient complains of headache and fever, some photophobia, and "just not feeling well." These symptoms began yesterday and appear to be getting worse. The podiatric physician notices that the patient moves slowly and carefully and that the neck is painful and somewhat stiff. Temperature is 103°F. There is no sign of head trauma, and the pupils are equal and reactive. The lungs and heart are normal. There is no skin rash. The left hip is slightly tender over the trochanter but has full range of motion. The patient appears neurologically intact. Which of the following is the most likely diagnosis for these acute symptoms?
1) Osteomyelitis
2) Lyme disease
3) Meningitis
4) Viral upper respiratory infection
