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A 2-year and 11-month old child fell while playing with friends 2 hours ago and has avoided bearing weight on the right leg since that time. The child is afebrile and exam reveals tenderness along the distal tibial shaft with no significant swelling. Radiographs are shown in Figure A and B. What is the most appropriate treatment?
MRI of the tibia
Aspiration of the tibia
Referral to child services
Long leg cast application
Serum vitamin D, calcium, and phosphate levels
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A 23-month-old girl refuses to bear weight since falling on the playground yesterday. The child is afebrile and her WBC and erythrocyte sedimentation rate (ESR) are within normal limits. On physical exam the leg has no erythema, but does have mild tenderness along the distal tibial shaft. Plain radiographs are negative. What is the most appropriate management?
vitamin D and calcium levels
MRI of the pelvis
long leg cast
aspiration of the knee
A 3-year-old male presents with inability to bear weight on his right leg for the past 3 days. They deny any known injury at that time. Examination reveals full motion of the right hip, knee, and ankle. He has tenderness to palpation over the anterior tibia with minimal swelling. No erythema is appreciated. His temperature is 99.6°F. He has no leukocytosis and CRP and ESR are normal. Radiographs of the right leg are seen in Figure A. What is the most likely diagnosis?l
Nondisplaced oblique or spiral fracture of the tibia with an intact fibula