1) Arthritis: This is the most common presenting symptom of ARF, occurring in three quarters of initial attacks. Classically, presentation is in the form of migratory polyarthritis--inflammation occurs in one or more joints, is present for two to three days and subsides as it then moves to another joint. However, with increased use of nonsteroidal anti-inflammatory drugs, arthritis may be confined to a single joint. The knees and ankles are most often affected, although the inability to weight-bear is indicative of hip joint involvement. An attack may last up to three weeks, resolving with no residual impairment of function. Arthritis manifests as redness, heat and swelling of the joint with limited movement. It is often very painful. (14,15)