FRACS Orthopaedic Exams

iSAWEs

A previously healthy nine-year-old boy was seen at the emergency department of a community hospital because of lower abdominal pain, nausea, and vomiting of a few hours' duration. At the time of physical examination, the patient had a low-grade fever and pain on palpation of the right lower quadrant of the abdomen. Bowel sounds were present. There were no other symptoms or findings. The neurologic evaluation showed 5 of 5 strength in all major muscle groups of the upper and lower extremities and no spasticity, hyperreflexia, or increased tonus or clonus. The remainder of the neurovascular examination was normal. After the initial evaluation, intravenous fluids were begun and, with symptomatic treatment, the symptoms resolved. A provisional diagnosis of acute appendicitis was deferred.

1. What is your diagnosis?
2. How will you treat this boy?

Webpage Last Modified: 16 July, 2011
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