മാഷ്

Eight year old boy who was otherwise normal had a fall from school and sustained mild bruise near his right knee. On the same day evening swelling started around the injury and within hours swelling spread around the joints. He was taken to the local hospital next day morning .Doctor aspirated knee joint and drew five cc of blood and he was referred as a case of hemarthrosis , as the trauma was trivial he thought better to rule out hemophila. At the time of admission   He looked sick , he had low grade fever . Pulse 86 regular good volume , BP 88 systolic .normal breathing. No jaundice, no rash no lymph nodes .mild pallor . Swelling around right knee extending upwards to the groin and down towards the tibia , but ankles were spared. As he wanted to confirm hemarthrosis and to rule out popliteal vessel compression USG was arranged. USG ruled out hemarthrosis. Blood vessels lower limb was normal . also checked abdoen ,chest . No free fluid in peritoneum pleural cavity and no signif