A two year old boy has asymmetric, painful swelling of the hands and feet

Question Number 0599

Question:
A three year old boy has asymmetric, painful swelling of the hands and feet. He has a history of frequent infections, including pneumococcal sepsis and salmonella osteomyelitis. On examination he is noted to have mild scleral icterus. Which of the above would be most useful in determining the diagnosis?

a) hemoglobin S
b) LE prep
c) rheumatoid factor
d) Antinuclear antibody
e) Anti-DNA


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