A 5-Year-Old Boy Is Brought to the Office Due to Left

A 5-year-old boy is brought to the office due to left wrist pain lasting a day.  His mother states that he refuses to use the left hand because of the pain.  The patient has no previous medical conditions and is up to date with immunizations.  He consumes a balanced diet.  Vital signs and growth parameters are within normal limits for his age.  On physical examination, the patient holds the left arm against his body.  There is tenderness of the left wrist with no visible deformity.  When instructed, the patient moves all fingers except the left thumb.  Radiograph of the left forearm is shown in the image below: Which of the following is the most likely cause of this patient's symptoms?

A) Avascular bone necrosis
B) Dietary vitamin D deficiency
C) Hematogenous osteomyelitis
D) Incomplete radial fracture
E) Primary bone malignancy

Correct Answer:

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