A patient was admitted to the hospital with usual pain symptoms for sickle cell/Hb-SS disease. Patient did not fill the pain medication prescription, and recent cold weather has brought on a vaso-occlusive crisis. Chest x-ray was performed and revealed evidence of acute chest syndrome. Patient has had right hip replacement for avascular necrosis and is scheduled to have the left hip replaced next month because of avascular necrosis, which is due to patient's sickle cell disease.Final Diagnosis: Sickle cell crisis with acute chest syndrome Status post hip replacement

Question

Quizplus · Accepted Answer

- D57.01: Sickle-cell disease, with crisis
- Z96.641: Presence of right artificial hip joint
- M90.552: Avascular necrosis of left hip, secondary to sickle-cell disease
- Z91.14: Patient's noncompliance with medications and health care, combined

Acute chest syndrome is a common complication of sickle cell disease characterized by chest pain, fever, cough, and shortness of breath. The patient's sickle cell crisis resulted in acute chest syndrome which was confirmed by the chest x-ray. The patient also had a status post right hip replacement for avascular necrosis secondary to sickle cell disease and is scheduled for left hip replacement due to the same reason. The patient's noncompliance with medications and healthcare added further to the complexity of the condition.

A Patient Was Admitted to the Hospital with Usual Pain