An 11-year-old girl with right ankle pain (page 1)

Prepared by.... Shanika Kosarat M.D.
Thanyawee Puthanakit M.D
Patient: An 11-year-old girl, Address: Chiang Mai
CC : Right ankle pain for 4 days
PI:
> 4 days PTA: She fell down while she was playing with her friends. She developed mild pain at right ankle since then, however she still walked normally.
> 3 days PTA: She developed high fever. Her right ankle was warm and swollen extended to her calf. She could not weight on her right ankle.
Past History:
She is the only one child in her family. She is deaf since she was young.
Immunization history is unknown.
Physical examination:
  GA: A girl, normal consciousness, no pallor, no jaundice, febrile
V/S: BT 39.7 C, PR 90/min, RR 26/min, BP 110/70 mmHg
HEENT: not pale, no icteric sclera, no injected pharynx and tonsil, TM- intact both sides
Heart: regular rhythm, normal S1 S2, no murmur
Lungs: clear, no adventitious sound
Abdomen: normal contour, normal bowel sound, no hepatosplenomegaly
Ext: Right leg; marked swelling and redness from just below right knee to right foot
Right ankle; marked swelling,limit ROM due to pain
Initial laboratory investigations:
  CBC : Hb 12.0 g/dl, Hct 37.2 %, WBC 13,700 (N 88%, L 2%, M 3%, E 1%) Platelet 327,000
ESR : 114 mm/ 60 min

What is your diagnosis?

Continue........... Next page

BACK to Interesting  Case List