What is the significance of the tests ordered in making the diagnosis of AOSD?
1.AOSD is a disease of exclusion. Evaluation for fever of unknown origin should be completed before diagnosis.
2.AOSD is diagnosed based on both clinical and laboratory features. M Yamaguchi et al has developed classification criteria for AOSD.

What are the typical features seen in this patient that are helpful in making the diagnosis of AOSD?
1.Fever with evanescent rash were typical for autoinflammatory disease.
2.The cause of sore throat in patients with AOSD was due to crico‐thyroid perichondritis.
3.Leukocytosis, ferritinemia, elevations in aspartate and alanine aminotransferase and lactate dehydrogenase were common.

What are the next steps in management of this patient? 
Patients with suspected AOSD should undergo grading to determine the treatment according to degree of activity, acute or chronic, systemic involvement or not and treat to target.

Patient Care (Case Correlation to ACGME Core Competency Requirements)
1.Understand the Yamaguchi's and Fautrel's criteria for adult-onset Still's disease.
2.Recognize the clinical manifestations of adult-onset Still's disease.
3.Obtain an appropriate history to determine if a patient might have AOSD.
4.Determine who should be referred to a rheumatologist for evaluation of fever of unknown.
5.Determine the appropriate serologic testing used to support the diagnosis of AOSD.
6.Identify the most severe complications of AOSD, macrophage activation syndrome.
7.Recognize the disease outcome and monitor for functional status of joints.

Medical Knowledge (Case Correlation to ACGME Core Competency Requirements)
1.Understand the evaluation of fever of unknown origin and rheumatic disorders among patients with fever of unknown origin.
2.Interpret the results of ANA and ENA testing
3.Recognize the manifestations of AOSD.

Practice-Based Learning and Improvement (Case Correlation to ACGME Core Competency Requirements)
1.Set goals for studying about AOSD pathophysiology, clinical manifestations, and treatment options.
2.Demonstrate the ability to review and interpret literature relevant to the care of patients with AOSD.

Practice-Based Learning and Improvement (Case Correlation to ACGME Core Competency Requirements)
1.Set goals for studying about AOSD pathophysiology, clinical manifestations, and treatment options.
2.Demonstrate the ability to review and interpret literature relevant to the care of patients with AOSD.

Interpersonal and Communication Skills (Case Correlation to ACGME Core Competency Requirements)
1.Discuss the results of lab testing with a patient.
2.Discuss the diagnosis of AOSD with a patient.
3.Discuss the need for appropriate follow up and monitoring with a patient
4.Comprehensively explain different treatment options based on disease manifestations

Professionalism (Case Correlation to ACGME Core Competency Requirements)
1.Recognize the importance of patient confidentiality and privacy.
2.Understand the need to provide supportive care.
3.Encourage patients to ask questions regarding their disease and empower them to be active participants in their care.
4.Provide adequate time and accessibility to address patient concerns.
5.Demonstrate an understanding of informed consent with regard to therapeutic options in the treatment of AOSD.

System-Based Practice (Case Correlation to ACGME Core Competency Requirements)
1.Create a team approach to manage patients with AOSD, engaging physicians from multiple disciplines.
2.Identify barriers to access and delivery of care for patients with complex, multi-system diseases.
3.Learn about resources available to improve delivery of care and patient support.
4.Identify the ways in which one can be a patient advocate, including obtaining prior authorization for medications, treatments, and diagnostic tests.
5.Demonstrate an awareness of the economic implications of a diagnosis of AOSD for the patient, and the potential impact on healthcare systems caring for patients with chronic conditions.