I would be worried about this kid.. Typically with Sickle Cell patients who
present with pain it is long bone pain ..Sometimes we see pain in the
vertebra or ribs ..Joint pain and especially when it is associated with
swelling /effusion should suggest aseptic necrosis or infection.. Was there
fever? Any history for contact with reptiles ( salmonella being a common
As for the use of sed rates. I can't document it but believe that they are
If it is elevated it would be helpful but a normal one is not ..That is a
sickler may not be able to generate an elevated sed rate ( opsonization
Anyway,, did you try to bounce this off the heme folks??What about ortho ??
A bone scan might have been helpfull too..
" Opinions expressed above are the authors, they may not be right but I
have the right to express them...
Martin Herman, M.D.
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