An efficient and accurate ear examination is dependent on the quality and condition of the equipment, an adequately restrained patient, and the ability to visualize the tympanic membrane (TM). The external auditory canal must be evaluated first. Edema, erythema, or otorrhea may indicate otitis externa or perforation of the TM.
This recent increase in measles should prompt pediatricians to exercise the same caution for measles as they would for exotic diseases and ensure that children are immune to measles before they travel.
A 15-year-old girl presented with yellowish papules on the cheeks and nose. The papules, which first appeared at age 5 years, had become more prominent and profuse in the past 4 years. The patient had recurrent episodes of generalized tonic-clonic seizures from age 2 to 6 years but had been seizure-free since then.
An 8-year-old boy presents to your office with persistent frontal headaches and diffuse neck pain of 2 weeks’ duration. His mother reports that for the past week he had been dragging his right foot while walking. The headache intensity is unaffected when treated with ibuprofen or acetaminophen.
I read with interest the What’s Your Diagnosis? feature, “Young Boy With Intermittent Leg Pain” (CONSULTANT FOR PEDIATRICIANS, June 2011, page 196). How would you tell the difference between a patient with growing pains and one with Meyer dysplasia, if both have normal physical examination and laboratory findings?
A baby girl, born at full term via spontaneous vaginal delivery, was noted to have swelling of the umbilical stump shortly after clamping of the cord. Over the next 3 days, the stump enlarged and became erythematous.
In a child who appears well but has vomiting without diarrhea, I often order a urinalysis to document urine output and specific gravity and measure glucose, bilirubin, and ketone levels. For the non–toilet trained child, a clean voided bag to obtain the urine specimen is useful.
A 3-month-old boy was brought for evaluation of a skin-colored, 1 × 3-cm, diffuse swelling in the right superior orbit area. The lesion had been slowly growing for the past month and was asymptomatic.
Often teenagers and young adults are surprised when I tell them that their skin has signs of sun damage. They erroneously believe that the solar lentigines on their face, chest, and shoulders have been there since birth or are normal.
A 4-year-old boy of Nicaraguan descent was hospitalized because of worsening periumbilical abdominal pain. The pain began 6 days earlier and was accompanied by decreased appetite, nausea, emesis, and diarrhea.
