24th August 2020

A 15-year-old girl is seen by her GP as her mother is concerned about her

A 15-year-old girl is seen by her GP as her mother is concerned about her. The mother mentions that her daughter has been having some pain in her right hip after physical activity. She denies losing any weight, has a normal BMI and denies experiencing any fevers or night sweats. On examination, the GP notices some tenderness on palpating the hip. He notices that the girl is able to stand up and weight bear but experiences discomfort on walking. The mother mentions that her daughter was born at term by vaginal delivery and has been fully immunised and vaccinated. The GP requests an X-ray (which shows no significant abnormalities) and some blood tests (shown below).

Which of the following diagnoses most likely explains the clinical picture and blood test results shown below for this patient? Normal ranges are given respectively in brackets.

• Haemoglobin: 12.0 (11.5-16.0 g/dL)
• Platelets: 275 (150-400 x109/L)
• APTT: 50 (35-45 seconds)
• PT: 12 (10-14 seconds)
• Fibrinogen:  2.0 (1.5-4.5 g/L)
• White Cell Count: 5.0 (4.0-11.0 x109/L)

Select the SINGLE most appropriate option from the list below. Select ONE option only.