Review Question - QID 217029

A 5-year-old boy presents to the emergency room with his parents with right arm pain. His parents say that he was playing in the backyard with his friend from school when he fell from ground level onto the grass. Since then, he has been crying inconsolably and holding his arm in pain. He did not hit his head or lose consciousness. Apart from 4 fractures from minor injuries, his medical history is unremarkable. The child is adopted and his birth parents are not known. His temperature is 98.6°F(37°C), blood pressure is 102/63 mmHg, pulse is 113/min, and respirations are 22/min. On physical exam, the patient is at the 8th percentile for height and 45th percentile for weight for his age. His strength in all non-injured extremities is 5/5. A Rinne test is performed and demonstrates minimal sound perception after the tuning fork is removed from the mastoid region, whereas a Weber test shows equal hearing in both ears. A photograph of the patient’s eyes is shown in Figure A. A radiograph of the right arm reveals a non-displaced fracture of the humerus with normal epiphyseal endplates. Which of the following is the most likely diagnosis?