Would you evaluate and manage a pediatric patient who has a painful swelling of the hands and feet, fatigue, or fussiness? Which diagnostic studies would you recommend for this patient and why?
Patient Mia presents with
...
Would you evaluate and manage a pediatric patient who has a painful swelling of the hands and feet, fatigue, or fussiness? Which diagnostic studies would you recommend for this patient and why?
Patient Mia presents with her mother with complaints of acute, severe, persistent right foot swelling with warmth and left hand/fingers swelling (dactylitis). Mother reports fatigue and fussiness. These symptoms are useful in narrowing the differential diagnosis for this patient. These symptoms are consistent with reactive arthritis in children, arthritis psoriatic, anemia sickle cell, arthritis septic, and rheumatoid arthritis.
It is important to order diagnostic studies to narrow diagnoses for this patient. Diagnostic test for this patient includes; complete blood count, antinuclear antibody, C- reactive protein, blood culture and sensitivity, left foot x-ray, right foot x-ray, liver function test, and erythrocyte sedimentation rate. Complete blood count indicates the number of red blood cells, the amount of hemoglobin and evaluates the size and shape of the red blood cells present. In patients with sickle cell anemia, there is no hemoglobin A (Pirenne, Bartolucci, & Habibi, 2017). An antinuclear antibody test identifies autoimmune diseases including lupus and rheumatoid arthritis (Burns, Dunn, Brady, Starr, & Blosser, 2016) C-reactive protein is a hepatocyte protein, an indicator of inflammation. C-reactive protein modulates inflammation in sickle cell disease (Burns et al., 2016). Blood culture and sensitivity test in sickle cell anemia identifies bacteremia and infection. Children with sickle cell anemia have an increase risk for developing infections including, pneumonia, and blood stream infections
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