12 yr boy with patchy hair loss ...with itching over period of 1yr


Rule out Hemophilia ,although no bleeding diathesis history ,check PT PTTK FACTOR 8,9 RHEUMATIC , ...CRP ESR ASO JRA ..... RA FACTOR ANA ANTI CCP

JIA (pauciarticular) subacute septic arthritis reactive arthitis blood for TC,DC,ESR,CRP,RA factor,anti ccp,diagnostic aspiration and biochemical,microbiological and culture-sensitivity. rest,icepack ,splint ,analgesics and anti inflammatory drugs

With history of illness of one day only, possible diagnosis may be Transient Synovitis or Reactive Arthritis, due to some autoimmune phenomena or crystal induced. CBC, CRP, serum uric acid,and aspiration and synovial fluid examination, would help in reaching to a reasonable diagnosis and management accordingly.

Acute onset without trauma male child Ist r/o hemophilia A or B send CBP with platelet count and morphology APTT most important. Then PT and BT and TT. Do USG thigh for any inflammatory swelling or abscess. II septic arthritis. If history not suggestive also r/o hemophilia. It depends on factor level may be first presentation. Pl inform the further course.

Was there h/o cough n cold. May b its a case of reactive arthiritis . What about sepsis markers r they wnl?

Dd JIA Mono articular Reactive arthritis Pyogenic arthritis Adv CBC, CRP, ESR, RAF, VDRL Rx symptomatic till diagnosis established

DD -- Hemarthrosis JIA Septic knee Post traumatic Brucella Hep b Tubercular Hsp Rhematic Investigation Cbc, esr, crp, urine, hbsag, BT, CT, PT, pTT Usg, aso, RA, ANA, ortho opinion

Alopecia areata

Alopecia areata r/0 Henson hypothyroidism

May be Swelling around knee may be generalized like in synovitis or hemarthrosis or localized like in bursa, ganglion, cyst or meniscus cyst...

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