<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 6-year-old boy is brought to the physician because of a 2-week history of fever and pain in his right thigh that is causing him to limp. The mother thinks he may have hurt himself during soccer practice. He has no history of rash or joint pain. His older sister has systemic lupus erythematosus. His immunizations are up-to-date. The patient is at the 40th percentile for height and 45th percentile for weight. His temperature is 39C 102.2F, pulse is 100min, respirations are 18min, and blood pressure is 11070 mm Hg. Examination shows swelling, tenderness, warmth, and mild erythema over the right upper thigh; range of motion is limited by pain. He has a right-sided antalgic gait. His leukocyte count is 12,300mm3 and erythrocyte sedimentation rate is 40 mmh. X-rays of the hips and lower extremities are unremarkable. An MRI of the right lower extremity shows increased T2 and decreased T1 signals over the right femur with periosteal elevation, multiple osteolytic areas in the femoral metaphysis, and bone marrow edema. Which of the following is the most appropriate next step in management?? A: Nafcillin therapy, B: Nuclear scan of the right upper leg, C: Femoral osteotomy, D: Arthrocentesis, E: Bone biopsy of the right femur,  <response>: This is a clinical vignette describing a 6-year-old boy with a 2-week history of fever, pain, swelling, tenderness, warmth, and erythema in his right thigh causing him to limp. He has no history of rash or joint pain. His sister has lupus. Physical exam shows limited range of motion of the right thigh due to pain and a right-sided antalgic gait. Lab tests show elevated WBC count and ESR. X-rays are unremarkable but MRI shows abnormalities of the right femur consistent with osteomyelitis. The key findings are a febrile child with focal bone pain, swelling and limited range of motion, elevated inflammatory markers, and MRI evidence of osteomyelitis of the right femur. The choices provided are different diagnostic and therapeutic options. Since the diagnosis of osteomyelitis seems clear based on the clinical presentation and MRI findings, the next step should be to confirm the diagnosis and identify the causative organism via bone biopsy of the affected femur. This will allow for targeted antibiotic therapy.E: Bone biopsy of the right femur 