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I am not sure that a sed rate can accurately differentiate sickle cell from
infecton in such a case.  I wonder how useful ultrasound would be in this case
to first show effusion and then give some indication of possible
osteomyelitis. Although I do not believe US has great sensitivity in early
cases of osteo I believe its specificity is probably better than that of a
bone scan in patients with crises, unless possibly if tagged wbc are used.
Possibly one of our pediatric radiology colleagues could shed some light on
this for us.
 
Randy Cordle MD
 
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