Exam 13: Appendicular Skeleton

Correct Answer:

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The purpose of the x-ray evaluation for the 10-year-old boy with a painful knee joint is to visualize the bony structures of the knee to determine if there is a fracture. In children, special consideration is given to the epiphyseal growth plate, which is the area of growing tissue near the ends of the long bones. Since the growth plates are the last portion of a child's bones to harden (ossify), they are particularly vulnerable to injury.

The growth plates are responsible for the longitudinal growth of bones, and an injury to these areas can potentially lead to growth disturbances or deformities if not properly diagnosed and treated. Therefore, the x-ray will help the physician assess not only the presence of a fracture but also whether the growth plate has been affected.

In summary, the x-ray examination is crucial for:

1. Diagnosing a potential fracture: It will show if there is a break in the bone and the type of fracture (e.g., displaced, non-displaced, comminuted, etc.).
2. Evaluating the growth plate: To check if the fracture involves the epiphyseal plate, which could have implications for the child's future bone growth.
3. Guiding treatment: Depending on the findings, the physician can determine the appropriate treatment, which may include immobilization, reduction (realigning the bone), or possibly surgery.
4. Establishing a baseline: If a growth plate injury is identified, the x-ray serves as a baseline for future comparisons to monitor healing and growth.

Given the patient's age and the potential for growth plate injuries, the x-ray is a critical diagnostic tool to ensure proper management of the injury and to minimize the risk of long-term complications.