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This case highlights the diagnostic complexity of AOSD and the importance of early consideration in patients with systemic inflammation and prolonged fever who have negative infectious and autoimmune testing.<\/jats:p>","DOI":"10.1136\/bcr-2025-267146","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T18:05:14Z","timestamp":1754330714000},"page":"e267146","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fever, joint pain, and systemic inflammation in a young adult: recognising adult-onset Still\u2019s disease"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3896-8978","authenticated-orcid":false,"given":"Lucas","family":"Goetz","sequence":"first","affiliation":[{"name":"Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanci","family":"Van Peursem","sequence":"additional","affiliation":[{"name":"Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bailey","family":"Thooft","sequence":"additional","affiliation":[{"name":"Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Modlin","sequence":"additional","affiliation":[{"name":"Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaihlen","family":"Smith","sequence":"additional","affiliation":[{"name":"Medicine, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"2025082722412742000_18.8.e267146.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.058"},{"key":"2025082722412742000_18.8.e267146.2","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.semarthrit.2019.04.004","article-title":"Racial\/Ethnic variations in morbidity and mortality in Adult Onset Still\u2019s Disease: An analysis of national dataset","volume":"49","author":"Mehta","year":"2019","journal-title":"Semin Arthritis Rheum"},{"key":"2025082722412742000_18.8.e267146.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.07.018"},{"key":"2025082722412742000_18.8.e267146.4","doi-asserted-by":"crossref","DOI":"10.1155\/2011\/184748","article-title":"Iron Deficiency Anemia in Adult Onset Still\u2019s Disease with a Serum Ferritin of 26,387\u2009\u03bcg\/L","volume":"2011","author":"Patel","year":"2011","journal-title":"Anemia"},{"key":"2025082722412742000_18.8.e267146.5","first-page":"424","article-title":"Preliminary criteria for classification of adult Still\u2019s disease","volume":"19","author":"Yamaguchi","year":"1992","journal-title":"J Rheumatol"},{"key":"2025082722412742000_18.8.e267146.6","doi-asserted-by":"crossref","unstructured":"Ruscitti P , Ursini F , Sota J , et al . The reduction of concomitant glucocorticoids dosage following treatment with IL-1 receptor antagonist in adult onset Still\u2019s disease. A systematic review and meta-analysis of observational studies. 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