<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 17-year-old boy is brought to the physician because of increasing pain and swelling of his right knee for 12 days. He has had episodes of pain with urination for 3 weeks. He had a painful, swollen left ankle joint that resolved without treatment one week ago. His mother has rheumatoid arthritis. He is sexually active with 2 female partners and uses condoms inconsistently. He appears anxious. His temperature is 38C 100.4F, pulse is 68min, and blood pressure is 10080 mm Hg. Examination shows bilateral inflammation of the conjunctiva. The right knee is tender, erythematous, and swollen; range of motion is limited by pain. There is tenderness at the left Achilles tendon insertion site. Genital examination shows no abnormalities. Laboratory studies show:Hemoglobin 14.5 gdLLeukocyte count 12,300mm3Platelet count 310,000mm3Erythrocyte sedimentation rate 38 mmhSerumUrea nitrogen 18 mgdLGlucose 89 mgdLCreatinine 1.0 mgdLUrineProtein negativeBlood negativeWBC 1216hpfRBC 12hpfAn ELISA test for HIV is negative. Arthrocentesis is done. The synovial fluid is cloudy and a Gram stain is negative. Analysis of the synovial fluid shows a leukocyte count of 26,000mm3 and 75 neutrophils. Which of the following is the most likely diagnosis?? A: Septic arthritis, B: Rheumatoid arthritis, C: Lyme arthritis, D: Reactive arthritis, E: Syphilitic arthritisn,  <response>: This is a clinical case scenario involving a 17-year-old boy with knee pain, urinary symptoms, and other joint issues. Key findings include:- Increasing right knee pain and swelling for 12 days- Episodes of painful urination for 3 weeks - Recent painful, swollen left ankle that resolved - Mother has rheumatoid arthritis- Sexually active with multiple partners, inconsistent condom use- Fever, conjunctivitis, right knee swelling and limited range of motion- Left Achilles tendon insertion tenderness- Elevated ESR, sterile pyuria- Cloudy synovial fluid with high WBC count and neutrophilsThis presentation is most consistent with reactive arthritis, which can follow certain infections and causes asymmetric joint inflammation. The urinary symptoms and sterile pyuria point to possible preceding urethritis. Conjunctivitis and Achilles tendon involvement are also typical of reactive arthritis. Septic arthritis would show bacteria on synovial fluid analysis. The distribution and time course make rheumatoid arthritis unlikely. There is no rash to suggest Lyme disease. Syphilis is possible but less likely given the negative RPR.D: Reactive arthritis 