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Posted On : 01/21/2019 12:30:25
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.
4
Expert Answer :
It may be coccygitis. Get her MRI lumbosacral spine to rule out a pathology around the coccyx.
Answer Discussion :
S
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

6 months ago
J
Jazlina Jamaludin
piriton dose
6 months ago
S
santosh ramaswamy
enthesitis related arthritis / do inflm markers/hla typ/ eye exam/ and a rheumatology opinion
6 months ago
W
Wassim
rheumatologist
7 months ago



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