Dr. Anil Sharma (Pediatrics) needs a second opinion on this medical case.
A 36 months old girl presented in out-door department with fever, severe back pain, difficulty in sitting and walking due to pain. Examination revealed pallor and generalized bony tenderness. Complete blood count showed anaemia (7.4 gm/dL) and normal counts (TC - 10,400 with 58% lymphocytes). A skeletal survey by radiography was done, which demonstrated extensive lytic lesions involving the skull, spine, visualized ribs, bilateral scapula, humerus, iliac bones, femur and tibia.
How we approach ?