Module 53, General Medical Level

This 9 year old girl was diagnosed as having sickle cell anemia during early childhood. She experienced two major crises each year, treated with hydration and pain medication. Her first bone symptoms occured at age 9 following a crises with concomitant left hip pain. Bone scan was also obtained which demonstrated a cold area.

Question 53A

At this age the most common bone problems are minor episodes of bone pain or infections.

Question 53B

The amount of pain, the level of the temperature, and the results of the bone scan all are helpful in ruling

out infection as cause.

Question 53C

A cold bone scan is conclusive evidence that this is a bone infarction.

Question 53D

The genetic syndrome of sickle cell disease has been identified on chromosome 11.

Question 53E

The concern about avascular necrosis of the hip at this age with a cold bone scan suggests that she should be placed on crutches until a clear documentation of the severity of the bone involvement can be ascertained.