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A 3-year-old African-American child presents with irritability, fever, and a warm, swollen leg. Imaging shows an area concerning for osteomyelitis and trans-cortical biopsy reveals multiple Salmonella species. This child most likely also has which of the following conditions?
Sickle cell anemia
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You are the team physician for a collegiate football team and receive weekly injury reports from the athletic trainer. All players with sickle-cell trait are listed at the bottom to remind all on-field personnel that they may need which of the following?
Oxygen supplementation and oral or IV hydration
Additonal layers of warm clothes
Increased pain medication
Avoidance of non-steroidal anti-inflammatory medicines
Days of rest due to increased joint pain
Hematogenous osteomyelitis caused by Salmonella is most common in which of the following patient populations?
Intravenous drug abusers
Patients with sickle cell disease
Patients with chronic kidney failure requiring dialysis
Patients with puncture wounds through athletic shoes
A 12-year-old boy with sickle cell anemia complains of 24 hours of pain in the right thigh. He denies any traumatic injury. The right leg has tenderness with palpation of the mid-thigh. The patient's temperature is 100.2 degrees F, and ESR is 45. Radiographs of the femur are unremarkable. A radionuclide bone scan demonstrates abnormal uptake in the mid-femur. A radionuclide bone marrow scan demonstrates decreased uptake within the marrow. Which of the following is the best step in management?
Symptomatic care for his pain with NWB crutches, intravenous hydration, and consultation with hematology
Steroid injection of the quadriceps
Two weeks of an oral cephalosporin and follow-up radiographs
Bone biopsy for culture and intravenous antibiotics
Surgical debridement, culture, and intravenous antibiotics
A 28-year-old African-American male with a history of Sickle Cell Disease complains of progressive left hip pain for the past two years. He denies any causative injuries. His images are shown in Figures A and B. Which of the following mechanisms is most likely responsible for his symptoms?
Blood disorder due to abnormal hemoglobin S alleles
Progressive slippage of physis though the hypertrophic zone
Osteomyelitis most likely due to Salmonella species
Accumulation of glycosaminoglycan breakdown products
COL5A1 or COL5A2 mutation