All of the following investigations are needed for evaluation of the given case except?
X ray wrist and elbow
Karyotype
Serum electrolytes
24 hour urinary chloride
The image shows clitoromegaly, labial fusion of a virilised female child. Inguinal folds don't exhibit any mass or swelling. The leading cause for this is congenital adrenal hyperplasia. Deficiency of 21-hydroxylase, resulting from mutations or deletions of CYP21A, is the most common form of CAH, accounting for more than 90% of cases. Choice A Useful for determining bone age which is advanced in CAH due to sex steroids Choice B Useful to identify CAH where a girl child has ambiguous genitalia Choice C Useful due to salt wasting and elevated potassium secondary to decreased aldosterone levels 24 hour urinary chloride is useful for renal tubular disorders like Bater syndrome and Gitelman syndrome.
Disorders of Adrenal Gland