INDEX OF SUSPICION

Abstract

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page. We invite readers to contribute case presentations and discussions. Case 1 Presentation A prepubertal 12-year-old boy who is obese (192 lbs, 68 in) is seen in the office for pain in the anterior and medial aspect of the left knee. The knee is not tender to palpation and has a range of motion equal to the normal right knee. He is in a weight-reduction program consisting of an 1800-calorie diet and supervised exercise four times per week. No history of trauma is elicited. Case 2 Presentation During the past 2 months, you have seen an 8-month-old boy twice for ear infections. At the last visit, 3 weeks ago, he also had a rash over his buttocks and in the perianal area that you treated with zinc oxide cream.