Pediatric | Figure 1

Pediatric Case

Case Summary:
A 4-year-old female presents with swelling on the plantar surface of her left foot that started yesterday. The onset was sudden and is associated with pain; she cannot walk.

The condition began 2 days ago with swelling on the palmar surface of her left hand which was seen by a pediatric consult. Analgesics were prescribed, and the swelling in her hand resolved. Subsequently, swelling appeared in her left foot, and she is unable to walk. An X-ray was done, which was reported as normal by the orthopedic consult. After a few hours, similar swelling appeared on the other foot as well.

Medical History:

• Free past medical and surgical history
• Family history of Familial Mediterranean Fever (FMF) and anemia

Examination:

• General exam: Patient appears well, but is not able to walk. She is oriented, comfortable, and cooperative.
• No fever.
• Local examination of the plantar surface of the left foot:
  • Slight tenderness,
  • Slight swelling,
  • Minimal bruising, and
  • Minimal point hemorrhage.

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