A 10-year-old sustained a spider bite on his ankle a week ago and now presents with redness, swelling, and tenderness. He denies any other fall or injury. X-ray of the ankle is unremarkable. CBC shows elevated WBC. What is the most likely diagnosis for this child?
Compartment syndrome
Osteomyelitis
Osteogenesis imperfecta
Juvenile idiopathic arthritis
The Correct Answer is B
Choice A reason:
Compartment syndrome is a condition where increased pressure within a muscle compartment leads to decreased blood flow, which can cause muscle and nerve damage. It is typically associated with severe trauma, fractures, or crush injuries. The symptoms include severe pain, swelling, and decreased sensation or movement in the affected limb. In this case, the child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are more indicative of an infection rather than compartment syndrome.
Choice B Reason:
Osteomyelitis is an infection of the bone, which can occur following an injury or infection elsewhere in the body. The symptoms include redness, swelling, tenderness, and pain in the affected area, along with fever and elevated WBC. Given the child’s history of a spider bite and the presence of redness, swelling, tenderness, and elevated WBC, osteomyelitis is the most likely diagnosis. The unremarkable X-ray does not rule out osteomyelitis, as early stages of the infection may not show changes on X-ray.
Choice C Reason:
Osteogenesis imperfecta, also known as brittle bone disease, is a genetic disorder characterized by fragile bones that break easily. It is not associated with infections or elevated WBC. The symptoms of osteogenesis imperfecta include frequent fractures, blue sclerae, and hearing loss. The child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are not consistent with osteogenesis imperfecta.
Choice D Reason:
Juvenile idiopathic arthritis (JIA) is a type of arthritis that occurs in children. It is characterized by persistent joint inflammation, pain, and swelling. While JIA can cause joint tenderness and swelling, it is not typically associated with a recent injury or infection, such as a spider bite. Additionally, JIA does not usually cause elevated WBC. The child’s symptoms are more indicative of an infection, making osteomyelitis the more likely diagnosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Basketball, while a popular sport, involves a significant amount of physical contact and the risk of falls and injuries1. For children with hemophilia, engaging in contact sports can increase the risk of bleeding episodes and joint damage. Therefore, basketball is not the most recommended sport for children with hemophilia.
Choice B reason:
Swimming is highly recommended for children with hemophilia because it is a low-impact sport that provides excellent cardiovascular exercise without putting undue stress on the joints. The buoyancy of the water supports the body, reducing the risk of injuries and bleeding episodes. Swimming also helps improve muscle strength and flexibility, which can be beneficial for overall health and well-being.
Choice C reason:
Soccer, like basketball, involves a lot of running, physical contact, and the potential for falls and injuries. These factors make soccer a less suitable sport for children with hemophilia, as it can increase the risk of bleeding and joint damage. Therefore, soccer is not the most recommended sport for children with hemophilia.
Choice D reason:
Skating, whether roller skating or ice skating, carries a risk of falls and injuries. While it can be a fun and enjoyable activity, the potential for accidents makes it less suitable for children with hemophilia. The risk of bleeding episodes and joint damage is higher with activities that involve a significant risk of falls.
Correct Answer is D
Explanation
Choice A: OI is Easily Treated
Osteogenesis imperfecta (OI) is not easily treated. It is a genetic disorder characterized by fragile bones that break easily. While there are treatments available to manage symptoms and improve quality of life, there is no cure for OI1. Treatments include medications to strengthen bones, physical therapy, and surgical procedures.
Choice B: With a Later Onset, the Disease Usually Runs a More Difficult Course
The severity of osteogenesis imperfecta can vary widely, but it is not necessarily true that a later onset leads to a more difficult course. The course of the disease depends on the type of OI and the specific genetic mutation involved. Some types of OI are more severe and present earlier in life, while others are milder and may not be diagnosed until later.
Choice C: Braces and PT Exercises are of No Therapeutic Value
This statement is incorrect. Braces and physical therapy (PT) exercises are valuable in managing osteogenesis imperfecta. Physical therapy helps in building muscle strength, improving joint movement, and preventing fractures. Braces can provide support for weak muscles, decrease pain, and keep joints properly aligned.
Choice D: OI is an Inherited Disorder
This statement is true. Osteogenesis imperfecta is a genetic disorder that is usually inherited in an autosomal dominant pattern. This means that a person only needs one copy of the defective gene from one parent to inherit the disorder. In some cases, OI can also occur due to a spontaneous mutation.
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