A child who refuses to ambulate.

摘要

A 2-year-old healthy girl presented with pain after falling on her right elbow 2 weeks prior to admission. She sustained a supracondylar fracture of the right humerus and was placed in a long arm cast. One week prior to admission she fell again on her right knee and developed localized pain in her right proximal tibia. This progressed to a refusal to ambulate prompting further evaluation. The tibial area was noted to be tender and swollen per parental report. Her review of systems was negative for fever, rashes, bleeding, and bruising. Her appetite and activity level remained normal. She did not appear pale. She did not have any cough, shortness of breath, nausea or emesis, or headache. Her past medical, surgical, and family history was unremarkable. Her social history was not concerning for nonaccidental trauma.