KNEE FLEX CONTRACTURE 1 YR OLD CHILD

[CHERRY KOVOOR]

Dear Friends

Kindly advice how to go about this case

1 yr old girl

Came with knee flexion Left deformity of 50 degrees. h/o fall at home 6 weeks ago and thereafter noticed swelling over the knee. Knee flexion deformity 50 degrees and further movements 50-130 degrees, Thickening synovium felt anteriorly, no warmth mildly tender

Blood counts- Total count =12600 [5000-15000]

                          Neutrophils- 26.6%

                          Lymphocytes 68%

                          Monocytes 3.3%

                           Eosinophils 1%

                           Basophils-0.2%

                           ESR -55 MM/HR[ 20]

                          CRP-8.5%  [< 5]

X-rays appear normal with respect to joint surface

 

Should I proceed with a synovial biopsy followed by serial casting to correct the deformity

 

Attaching x-rays

 

Regards

 

DR C CHERIYAN KOVOOR

KOCHI

INDIA