All of the following investigations are needed for evaluation of the given case except?
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.
X ray wrist and elbow
Karyotype
Serum electrolytes
24 hour urinary chloride
Disorders of Adrenal Gland