A 12-year-old girl complains of left knee pain and swelling that resulted from a collision with another player while she was playing kickball the day before. Her left foot was planted as she tried to catch a ball, and she was hit on the outside of the left knee. She fell to the ground and was unable to walk on the injured leg; overnight, the knee became more swollen and painful.
An 8-year-old boy is assessed on the same day that he passed red-colored urine. The boy first noted the abnormal-colored urine when he voided on awakening.
Key words: type 2 diabetes melllitus, childhood obesity
The patient is an 8-year-old girl with a history of asthma and developmental delay. She complained of hip pain, and her pediatrician referred her to a pediatric orthopedist for consultation. Hip x-ray films were ordered; they revealed 3 round beads in the child's appendix.
Photo Finish: Acute Dx: What Cause of Sudden Illness?
A 16-year-old girl with type 1 diabetes mellitus had had asymptomatic, sharply demarcated, waxy plaques, with atrophic, shiny centers, in both pretibial areas for several years.
A 7-week-old white boy presented to the emergency department (ED) with vomiting and weight loss. His parents brought him to the ED 3 weeks earlier after he had vomited for several days. Possible milk protein allergy was diagnosed at that visit, and a change from cow milk formula to an elemental formula was recommended. Vomiting subsequently increased in frequency. Nonbilious but forceful vomiting occurred with each feeding. The patient lost nearly 2 lb during the 3 weeks that followed the first ED visit.
An otherwise healthy 11-month-old infant hadhad an intermittent, nonpruritic rash for mostof his life. The lesions recurred mainly onthe extremities and trunk without a particulartrigger. Applications of 1% hydrocortisonecream were only partially beneficial. The joints and nailswere not affected. The patient’s maternal grandfather hadsevere psoriasis.
A white ring recently developed around this lesion on the upper back of a 15-year-old boy. Is there any reason for concern--and what clues would you use to suggest the need for a biopsy?
During their physical examination of this infant who had been born at term via cesarean section, Richard W. Hartmann, Jr, MD, and J. Christiane Salansky, MD, of Halifax Medical Center, Daytona Beach, Fla, found no evidence of an external anal opening (A). A soft bulge was present at the anal site, and the external sphincter was palpable. The median raphe was thick; a drop of meconium was noted on the surface of the perineum midway from the anus to the base of the scrotum (B). The remainder of the examination findings were normal.
Photo Essay: The Butterfly Technique: A New Method of Inserting an Umbilical Vessel Catheter
Six-month-old girl with dysmorphic appearance referred for genetic evaluation. Child is a product of a fraternal twin pregnancy; born at 41 weeks gestational age. Mother, age 32, received no prenatal care. Paternal age, 41 years.
