LAUSR

We present the case of a girl aged 6 years presenting with increasingly severe tibial pain and lameness of 10 days’ duration in the absence of fever or recent trauma. Both the patient and her mother had a previous diagnosis of hemoglobin (Hb) C trait, while her father had received a diagnosis of sickle cell trait. The patient reported having experienced several episodes of bone pain in different locations of her upper and lower extremities in the last year. The physical examination revealed pain in the right proximal tibial metaphysis on palpation, with no other relevant findings. Blood tests showed elevation of C-reactive protein (7.9 mg/dL), lactate dehydrogenase (420 mg/dL) and bilirubin (1.4 mg/dL), while the results of the complete blood count, coagulation tests and other biochemical tests were all normal. The findings of plain radiography were unremarkable, so bone scintigraphy was performed on the suspicion of chronic nonbacterial osteomyelitis based on the previous history of recurrent episodes of musculoskeletal pain. Since scintigraphy only revealed abnormal uptake at the tibial metaphysis, the decision was made to perform an MRI scan, which revealed an extensive acute bone