Abstract

A 3-year-old boy was admitted for a right oblique femur fracture after a fall from a bed (Figure 1). Non-accidental trauma was ruled out. On exam, his height was at the 90th percentile, weight at the 50th percentile, and body mass index at the 24th percentile for age and sex. He had normal sclerae and dentition. He had significant proptosis, a goiter measuring 3 times normal size and rubbery in texture, tongue fasciculations, and hand tremors (Figures 2 and 3). Laboratory values were consistent with hyperthyroidism: T3 816 ng/mL, Free T4 9 ng/dL, and thyroid stimulating hormone <0.03 IU/mL.

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