07-14-2006, 10:55 PM
A 4-year-old girl is brought to a specialty clinic by her foster parents because of a limp in her right leg and a serum alkaline phosphatase (ALP) that is 10 times the adult upper limit of normal for the test. The child is withdrawn and clinging to her foster mother. Physical examination is remarkable for a blue-green discoloration of the skin overlying a tender, 3-cm mass on the anterior portion of the right mid-thigh. An x-ray of the right thigh reveals a dense mass within the femur that extends into the surrounding tissue. Which of the following best describes the increased alkaline phosphatase and physical findings in this case?
A. ALP is abnormal for her age and the bone lesion represents an area of aseptic necrosis
B. ALP is abnormal for her age and the bone lesion represents repair of a femoral fracture
C. ALP is abnormal for her age and is unrelated to the bone lesion
D. ALP is normal for her age and the bone lesion is an osteogenic sarcoma
E. ALP is normal for her age and is unrelated to the bone lesion
A. ALP is abnormal for her age and the bone lesion represents an area of aseptic necrosis
B. ALP is abnormal for her age and the bone lesion represents repair of a femoral fracture
C. ALP is abnormal for her age and is unrelated to the bone lesion
D. ALP is normal for her age and the bone lesion is an osteogenic sarcoma
E. ALP is normal for her age and is unrelated to the bone lesion
