Question of the Week

Question :
Posted On : 21 Jan 2019
2 1, 2 y, o female with no previous PMH c, o sacral pain, almost daily for the past 6 months. No fever, vomiting, diarrhea, normal soft to formed bowel movements 1-2 x, day, no abdominal pain, no excessive flatulence, no trauma, no numbness, tingling in legs, no bed-wetting {fully toilet trained from 1 months} dysuria, hematuria, no travel, no peri-rectal itching.
Pain began in lower sacral, coccyx area approximately 6 months ago, with intermittent complaints of pain with sitting only. She would prefer to sit in padded seats. Now pain is daily, especially with sitting, but also occurs with ambulation, lying down. It does not stop her from her activities, but she will cry with discomfort at times, and even complain that clothes on the skin are bothersome and will prefer to have them off. There are no reports of rash or dry skin over the area in question.
On physical, she had a completely benign head to toe examination with only questionable discomfort with palpating over her coccyx area. When distrated, the discomfort was not noted. There was a normal anal wink, guaiac of stool was negative, and there was no evidence of abuse.
An x-ray of the lower spine, sacrum was wnl. We are in the process of doing a pin worm test.
Any suggestions on how to proceed_? Any specialist you would consult at this time.
Expert Answer :
It may be coccygitis. Get her MRI lumbosacral spine to rule out a pathology around the coccyx.
Answer Discussion :
Sanjay yadav
with a chronic history and a female child need to rule out CTD,
if any limp pls rule out Leg-caves perthes disease

2 years ago
Jazlina Jamaludin
piriton dose
2 years ago
santosh ramaswamy
enthesitis related arthritis / do inflm markers/hla typ/ eye exam/ and a rheumatology opinion
2 years ago
2 years ago

Disclaimer: The information given by is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0