{"title":"Chronic Leg Pain","authors":"Sebastian, Chang, Timothy Brow","doi":"10.1542/9781610024570-ch07","DOIUrl":"https://doi.org/10.1542/9781610024570-ch07","url":null,"abstract":"A 52-year-old man, on long-term steroids for asthma, presented to neurologists in mid-1993 with a 5-month history of bilateral shin pain. It increased throughout the day, especially on standing and eased at rest. They noted a patch of decreased sensation to pin-prick, temperature and light touch in the left L5 distribution, but electromyography and computed tomography of the lumbar spine showed no nerve impingement. He was investigated by a rheumatology team in October 1993, and because of a previous history of sarcoid lung disease, an isotope bone scan was arranged, which was normal. He was seen by an orthopaedic team in 1994 and magnetic resonance imaging showed \"moderate sized L5/S 1 disc protrusion, not clinically significant with no evidence of spinal stenosis\". Concurrently, he was also investigated by a vascular team; Dop-pler studies of both limbs were normal, but unfortunately he did not attend a transfemoral angiogram to exclude aorto-iliac disease. He remained symptomatic and was seen by the vascular team again whilst in hospital for respiratory problems in January 1996. Examination revealed a tender anterior compartment and Duplex studies showed the muscles in the involved compartment * sensory deficit to light touch, pin-prick, 2-point discrimination in the distal sensory distribution *","PeriodicalId":184875,"journal":{"name":"Challenging Cases in Pediatric Hospital Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122692015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Newborn With Black Stools","authors":"","doi":"10.1542/9781610024570-ch32","DOIUrl":"https://doi.org/10.1542/9781610024570-ch32","url":null,"abstract":"","PeriodicalId":184875,"journal":{"name":"Challenging Cases in Pediatric Hospital Medicine","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114297258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Newborn With In Utero Polysubstance Exposure","authors":"","doi":"10.1542/9781610024570-ch22","DOIUrl":"https://doi.org/10.1542/9781610024570-ch22","url":null,"abstract":"","PeriodicalId":184875,"journal":{"name":"Challenging Cases in Pediatric Hospital Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124827141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incomplete Maternal History Confounding the Diagnosis","authors":"","doi":"10.1542/9781610024570-ch37","DOIUrl":"https://doi.org/10.1542/9781610024570-ch37","url":null,"abstract":"","PeriodicalId":184875,"journal":{"name":"Challenging Cases in Pediatric Hospital Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131503532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ventriculoperitoneal Shunt Complications","authors":"","doi":"10.1542/9781610024570-ch34","DOIUrl":"https://doi.org/10.1542/9781610024570-ch34","url":null,"abstract":"The evaluation of children with suspected ventriculoperitoneal shunt (VPS) malfunction has evolved into a diagnostic dilemma. This patient population is vulnerable not only to the medical risks of hydrocephalus and surgical complications but also to silent but harmful effects of ionizing radiation secondary to imaging used to evaluate shunt efficacy and patency. The combination of increased medical awareness regarding ionizing radiation and public concern has generated desire to reduce the reliance on head computed tomography (CT) for the evaluation of VPS malfunction. Many centers have started to investigate the utility of low dose computed tomography and alternatives, such as fast magnetic resonance imaging for the investigation of VP shunt malfunction in order to keep radiation exposure as low as reasonably achievable.","PeriodicalId":184875,"journal":{"name":"Challenging Cases in Pediatric Hospital Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128107714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}