What is the most likely associated finding in a child with hypertension and characteristic physical examination findings of Turner syndrome?

In children with Turner syndrome, hypertension is often associated with cardiovascular anomalies, particularly coarctation of the aorta. One common physical examination finding in such cases is the characteristic "notching" of the ribs, which can be seen on a chest X-ray. This is caused by eroded ribs as a result of collateral circulation developing due to the aortic coarctation.

Notching of the ribs indicates that there are significant changes in the circulation as the body attempts to compensate for the impeded blood flow caused by the coarctation. This finding is a classic radiological manifestation related to the associated complications of Turner syndrome and highlights the systemic effects of the condition.

The other options provided do not typically correlate with Turner syndrome in the context of associated hypertension and its characteristic signs. Increased urine homovanillic acid (HVA) and vanillylmandelic acid (VMA) would suggest a diagnosis of a neuroblastoma or pheochromocytoma rather than something typical for Turner syndrome. Sensorineural hearing loss and hematuria are relevant to Turner syndrome but are less directly associated with hypertension as defined in the question. Tonsillar hypertrophy is common in children, but it is not a specific finding associated with