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A 15-Month-Old Boy Is Brought to the Emergency Department Due

question 368

Multiple Choice

A 15-month-old boy is brought to the emergency department due to refusal to stand. Earlier today, the patient fell from a standing height after tripping on toys. The event was witnessed by several employees at the day care that he has been attending for a week. He cried initially but was consoled and continued playing. At home, however, he was unwilling to walk or bear weight on his right leg. The patient has met appropriate growth parameters and developmental milestones. Weight and height are at the 75th percentile. Temperature is 37.7 C (99.9 F) . The patient is sitting comfortably in his mother's lap. The abdomen is soft with no organomegaly. The right distal tibia is slightly edematous compared with the left. Palpation over the right distal tibia elicits crying. Skin examination shows scattered bruises on the bilateral knees and lower legs. The radiograph is shown in the image below: In addition to leg immobilization, which of the following is the best next step in evaluation of this patient?

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