A Near Miss: Worsening Immobility In A 10 Year-old Female After A Fall

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A Near Miss: Worsening Immobility In A 10 Year-old Female After A Fall - Page #3

Lab Studies: CMP showed an elevated potassium of 5.3 and total bilirubin of 1.7. CBC was within normal limits. Other Studies: A left knee X-ray was done with a possible shallow trochlear angle with no other noted abnormalities. Lateral X-rays of the knees showed widening of the left proximal tibial apophysis Case Photo #1 compared to the right side. The patient was diagnosed with a Salter-Harris type I fracture of the proximal tibia. Bilateral knee X-rays were repeated, showing osteopenia with no acute osseous abnormalities or malalignment and no findings to suggest Osgood-Schlatter disease. The tenderness at the tibial tuberosity improved though the patient had difficulty walking and was unable to sit comfortably with tenderness to palpation over the left lateral and posterior hip. The patient noted pain over her left hip and decreased ROM at her third appointment. Anterior-posterior and lateral X-rays of the hip showed an irregularity at the capital femoral epiphysis with displacement and shortening Case Photo #2 . Consultations: Orthopedics and sports medicine Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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