Module 65, General Medical Level

This patient is a six year old male with a three week history of right foot pain. The mother and patient relate no history of trauma. Patient came home from school three weeks ago with pain and swelling over the medial aspect of the right foot. Symptoms have persisted for past three weeks. Mother states patient has been ambulating with a limp. There is tenderness to palpation and minimal swelling over the medial aspect of the right navicular.

Question 65A

This is typical of incidental childhood trauma. Instruct the mother to give the child Tylenol and come back for repeat examination if not improved in 2 weeks.

Question 65B

An x-ray of the foot should be obtained if this is to be worked up further.

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Question 65C

A careful history for possible infectious illness should be obtained.

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Question 65D

Ankle sprain from rough play is a common cause of this type of symptom in children.

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Question 65E

This could be typical growing pains.

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