A ten-year old girl presents with swelling of one knee joint. All of the following conditions can be considered in the differential diagnosis, except:

1. Tuberculosis.
2. Juvenile rheumatoid arthritis.
3. Haemophilia.
4. Villonodular synovitis.



Answer

3. Haemophilia.

Reference

All texts that deal with X Linked Recessive inheritance

Quality

Thinker

Status

New

QTDF

Common Sense

Discussion

Read the question carefully and see that the question does not ask “ What cannot occur in a girl”. The question is very clinical. In usual practise, All can be diagnosed as Differential Diagnosis in a Girl except  a X linked Recessive Disease. If you are given a case of knee joint swelling in a girl in your Final MBBS, will you write Hemophilia as one of your DD !!!

Explanation

1. Tuberculosis can occur in both boys and girls.

2. Juvenile rheumatoid arthritis can occur in both boys and girls.

3. Haemophilia is not a DD when you are examining a girl. (Eventhough hemop[hilia CAN occur in girls)

4. Villonodular synovitis can occur in both boys and girls.

Comments

Could it be Hemophilia !!!! Remote possibility !!!!!

But be very careful if you get a question like this

swelling of one joint is seen in or .........

swelling of one joint is not seen in……..

Tips

Prepare the conditions causing

·         Swelling of one joint,

·         swelling of more than one joint at different times and

·         swelling of many joints simultaneously