Pediatric Pictures Flashcards by Saloni Paudel

What is this?

Dermoid cyst

saclike growths present at birth
are like teratomas (can contain hair & teeth)
often associated with tufts or sinuses
grow slowly
can get infected
should be REMOVED

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What type of rash is this?

Psoriasis

Auspitz sign - punctate bleeding when scales removed
can go into inguinal folds

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What type of rash is this?

Nummular Eczema

on extensor surfaces of extremities
lesions are uniform
may ooze, crust or have a scaling pattern
treat with steroids

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What is this?

Pediculosis Pubis

Pubic Lice or Crabs

infection in the groin
red, crusted suprapubic macules and possibly bluish-gray dots.
STRONG ASSOCIATION with sexual abuse in children.

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Whats is this?

Erythema Chronicum Migrans

caused by BORRELIA BURGDORFERI, that causes LYME DISEASE.
large, flat lesion (> 5 cm); a “bulls eye” lesion. Shows up 1–2 weeks after the bite.
transmitted via the Ixodes deer tick.
Lyme antibody titers. If these are positive, confirm with a Western blot.
Treat: ORAL medication (doxycycline if >8 years old, or penicillin or amoxicillin if < 8 years old). If the patient has CARDITIS, neuritis (encephalitis/‌meningitis), or RECURRENT arthritis, treat with IV medication (PCN or ceftriaxone)

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What syndrome is this?

Klippel-Feil Syndrome

fused cervical vertebrae
torticollis-like appearance
short, webbed neck, limited range of motion at neck
associated with Sprengel’s anomaly (elevated & medial rotation of scapula)

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What type of rash is this?

Harlequin Ichthyosis

covering is hard (“armor-like”) and horny
movement is restricted
poor prognosis

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What is this caused by?

Scabies

linear, papular, erythematous, pruritic, vesicular, and crusting lesions
often seen in areas with CREASES (wrist, groin, webbing of fingers). You may see burrows.
Treat: permethrin overnight from head to toe for the entire family.
Re-treat if the patient is still having symptoms after 14 days and LIVE MITES are found
persisting pruritis can be from residual inflammation.

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What syndrome is this seen in?

Klippel-Trenaunay Syndrome

associated with AV fistula, causing skeletal or limb overgrowth (HEMIHYPERTROPHY)
port wine stain
Look for unilateral limb overgrowth and CHF

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What type of rash is this?

Lamellar Ichthyosis

Collodion Baby

noted at the time of birth
thin transparent film
eyelashes are missing
eyelids seem everted (ectropion)

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What is this?

Livedo Reticularis

AKA Cutis Marmorata

a mottled, reticulate patterned rash and may be described as a lacy rash.
benign
resolves by 1 month.

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What syndrome is this?

McCune Albright Syndrome

Polyostotic Fibrous Dysplasia

irregular cafe-au-lait macules (> 3 cm or multiple)
precocious puberty
bone problems (long bone fractures & bowing of arms)
endocrine issues (hyperthyroidism)

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What causes this type of rash?

Zinc Deficiency

SCALY and EXTREMELY ERYTHEMATOUSdermatitis in the perioral and perianal area (around the natural orifices) that can DESQUAMATE.
The rash is sometimes described as erosive and eczematous.
It can also be associated with ALOPECIA and poor taste.
Breastfeeding helps with zinc absorption.

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What is this seen in?

Incontinentia Pigmenti

severe X-linked DOMINANT; only seen in FEMALES
DEATH IN ALL MALES
4 stages of the rash: inflammatory vesicular phase; followed by a verrous phase; hyperpigmented phase along the lines of Blaschko; atrophy or hypopigmentation
delayed dentition, mental retardation, paralysis, peg teeth, seizures

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What is this?

Impetigo

Bullous impetigo
- honey colored crusting lesions + bullae
- staph auresu
Non-bullous impetigo
- honey colored crusting lesions w/o bullae (more crusting/oozing)
- staph or strep

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What type of rash is this?

Lichen Sclerosus

found in genital area
no thickening or sclerosis
no symptoms or some pruritis

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What is this rash?

Neonatal Acne

AKA Neonatal Cephalic Pustulosis

occurs within the first month of life
resolves by 4 months of age.
inflammatory pustules on the cheeks and forehead without comedones.
a benign rash that requires no treatment.

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What is this?

Hutchinson Teeth

found in late CONGENITAL SYPHILIS
have nothes on the biting surface

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What is this?

Alopecia Areata

round/well-circumscribed area(s) of alopecia.
can be on the scalp or in other areas.
Hairs at the periphery of the areas are short, pluckable, and may resemble an exclamation point!

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What Syndrome is this associated with?

PHACES SYNDROME

Postrior fossa malformation (Dandy Walker)
Hemangioma (large segmental hemangioma on the face) - associated with strokes
Arterial cerebrovascular anomaly
Cardiac anomalies (Coarctation of aorta)
Eye anomalies (micropthalmia, strabismus)
Sternal defect

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What is this hair condition?

Alopecia Totalis

the loss of all hair on the HEAD.
Alopecia universalis is the loss of all hair on the entire BODY. There is usually a SYSTEMIC etiology such as hypothyroidism, a nutritional deficiency, or even lupus (SLE).

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What is this type of hair loss called?

Telogen Effluvium

a form of acute hair shedding that occurs diffusely.
“thinning” of the hair.
The hair that is shed can be recognized by a small bulb of keratin on the root end.
often related to a psychological or medical stressor.
Treat with REASSURANCE because the hair will grow back.

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What is this?

Erythema Marginatum

a transient, erythematous, macular and light colored.
“SERPENTiginous” (snakelike) and the MARGINs are noted to progress as the center clears.
It is part of the Jones criteria for Rheumatic Fever.

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What is this?

Miliria Rubra

very superficial vesicles that are easily ruptured
occurs due to obstruction of sweat glands
also called “prickly heat rash.”

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**What is this rash?**

**Acrodermatitis Enteropathica** ## Footnote * autosomal recessive * a zinc transport defect. * alopecia, diarrhea, failure to thrive (FTT), and the rash of zinc deficiency. * will present once baby is weaned off breast mik

**What is this?**

**Tinea Corporis** * thin, circular lesion with thin scales, raised border and central clearing

**What type of rash is this?**

**Ecthyma Gangrenosum** ## Footnote * a sign of Pseudomonas infection and possibly sepsis * immunocompromised patient, Leukemia * neutopenic patient * black, necrotic, ulcerative lesions with surrounding erythema and edema * often located in groin/diaper area

**What is this rash called?**

**Transient Neonatal Pustular Melanosis** * more common in African-American kids. * a benign rash with NO associated erythema. * starts in utero and is PRESENT AT BIRTH. * resolves within a few days but can leave hyperpigmented macules for a while. * Diagnose: PMNs on Tzanck smear.

**What type of rash is this?**

**Cutaneous Candidiasis** ## Footnote **Diaper Dermatitis** * satellite lesion * goes into the inguinal folds * confirm with KOH prep * treat with topical nystatin or clotrimazole

**What is this?**

**Aplasia Cutis Congenita** * congenital absence of the skin in an area. * usually in a single location (most often the scalp) but can be in multiple areas. * After the lesion heals and scars, a BALD SPOT is left behind. * can be associated with underlying spinal dysraphisms and underlying skull defects. * Look for the HAIR COLLAR SIGN. This is a hairless area with a collar of dense hair at the edges. If given a picture of a scalp with the hair collar sign, get an MRI.

**What type of rash is this?**

**Atopic Dermatitis** ## Footnote **(Eczema)** * pruritic and lichenified * spares diaper folds and flexural surfaces in babies * treat with low potency topical steroids

**What type of rash is this?**

**Granuloma Annulare** ## Footnote * annular (circular) lesion * slightly pruritic * NO SCALES * looks like a ringworm without scales

**What is this seen in?**

**Neonatal Lupus** ## Footnote * Baby does NOT have lupus * due to maternal SLE-related antibodies (Ro and La) * Increased LFTs, petechiae, thrombocytopenia, 3rd degree AV block with bradycardia, or hydrops fetalis * Diagnose: anti-Ro or anti-La antibodies (anti-SSA or SSB)

**What type of rash is this?**

**Erythema Multiforme** ## Footnote * tiny target lesions * start on the hand and/or feet and then progress to trunk * 0-1 mucuous membrane involved (if more = SJS or TEN) * patient is not toxic * possible etiologies: HSV, Mycoplasma, Syphilis

**What is this?**

**Tinea Versicolor** ## Footnote * hypopigmented or hyperpigmented macules * caused by Malassezia Furfur * florescense under Wood's lamp * Treat: * topical: selenium or zinc anti-dandruff shampoo * oral: Fluconazole or Ketoconazole

**What is this?**

**Sebaceous Hyperplasia** ## Footnote * pinpoint white-yellow papules appear on the nose and central face. * There is NO associated erythema. * due to maternal androgen exposure * benign.

**What is this?**

**Herpes Simplex Virus** ## Footnote * HSV 1 (gingivostomatitis); HSV 2 (STD) * very painful lesions, fever, and lymphadenopathy * multiple painful ulcers or vesicles on the labia or penis (HSV-2) or in and around the mouth (HSV-1) * vesicles are CLUSTERED on an ERYTHEMATOUS BASE * Diagnose: viral culture or HSV PCR * Treat: ORAL Acyclovir x 7 days (IV in babies)

**What is this syndrome called?**

**Blueberry Muffin Syndrome** ## Footnote * represents extramedullary hematopoiesis. * can be seen in congenital viral infections such as Rubella, Coxsackie, Cytomegalovirus (CMV), Herpes Simplex Virus (HSV), and Parvovirus. * can also be associated with congenital Toxoplasmosis (a protozoa).

**What is this?**

**Nevus Simplex** ## Footnote **Stork bite or Salmon patch** * salmon colored lesion; blanch on pressure * midline or symmetrical (on both eyelids) * fade with time * benign

**What type of rash is this?**

**Pyoderma Gangrenosum** ## Footnote * unknown etiology * associated with other systemic diseases like Crohn's * deep, bluish, necrotic and boggy looking ulcers

**What type of rash is this?**

**Keratosis Pilaris** ## Footnote * overgrowth of the horny skin * can look similar to eczema

**What is this?**

**Pediculosis Capitis** ## Footnote * nits/ova of the lice at the hair shafts * more symptoms at night when lice tend to be more active. * Itching is from the bites. * Treat with permethrin. Repeat again in 7–10 days because eggs can hatch up to 10 days later.

**What is this?**

**Fluorosis** ## Footnote * mottled discoloration of teeth * due to excess flourine use during tooth development (up to age 4)

**What syndrome is this?**

**Kasabach-Merritt Syndrome** ## Footnote * large, congenital vascular tumor * not true hemangiomas * can cause a severe CONSUMPTIVE COAGULOPATHY * thrombocytopenia * risk of bleeding and death * most common in infants

**What is this caused by?**

**Tetracycline** ## Footnote **Tetracycline Teeth Staining** * yellow, brown, or blue band-like stains * Avoid tetracycline in patients younger than 8 years of age

**What is this?**

**Milia** ## Footnote * small, pearly inclusion cysts that look like little white heads. * There’s NO associated erythema. * If milia are on the nose, they can be very easy to confuse with SEBACEOUS HYPERPLASIA.

**What is this?**

**Erythema Toxicum Neonatorum** ## Footnote * erythematous macules with raised central lesions (papules or vesicles). * usually seen at birth or by DOL 2. * benign rash with an unknown etiology. * usually disappears by DOL 7. * Diagnose by noting eosinophils on microscopy.

**What type of rash is this?**

**Vitiligo** ## Footnote * depigmented macules * "salt and pepper" type of pattern or re-pigmentation * often associated with HALO NEVI

**What is this?**

**Condyloma Acuminata** ## Footnote **Genital Warts** * caused by HPV * 6 and 11 (warts); 16 and 18 (cervical cancer) * can be due to maternal-fetal transmission and may not present until 3 years after birth * Lesions are NOT tender but easily bleed with minimal trauma * Treat: podofilox, imiquimod, podophyllin, cryotherapy

**What is this?**

**Pityriasis Rosea** ## Footnote * oval, parallel lesions with THICK scales * herald's patch (1st lesion) * "christmas tree pattern" * winter and spring * Treat: light exposure

**What is this?**

**Erythema Nodosum** ## Footnote * PAINFUL, shiny, red to bluish skin lesions * a patient with a history of a chronic disease or on certain medications. * Associations include Crohn’s Disease, Ulcerative Colitis, Drugs (oral contraceptives and sulfa drugs), Infections (Yersinia, EBV, Tuberculosis, fungal infections), and Sarcoidosis.

**What type of rash is this?**

**Langerhans Cell Histiocytosis** ## Footnote **Histiocytosis X** * papular rash with petechiae (sometimes) * in the folds (inguinal, supra-pubic, perineal) * can resemble eczema * lytic bone lesions (skull) * can be associated with Diabetes Insipidus * Treat: remove lesion, steroids +/- chemotherapy * PEARLS: If they describe an eczema or seborrheic dermatitis type of rash in a patient with high urine output, LCH is your diagnosis.

**What type of rash is this?**

**Icthyosis Vulgaris** ## Footnote * rash resembles fish scales * often seen in atopic dermatitis * Treat: ammonium lactate

**What type of rash is this?**

**Urticaria** ## Footnote **Hives** * pruritc rash due to an allergic exposure * pink center with a more erythematous border * Treat: histamine blocker (both H1 & H2) * Foods are the most likely cause of chronic urticaria

**What type of rash is this?**

**Eczema Herpeticum** ## Footnote * potentially life threatening disseminated HSV infection * HSV vesicles + crusted lesions * not improving with steroids and/or antibiotics * viral culture for HSV * treat with Acyclovir

**What is this seen in?**

**Tuberous Sclerosus** * Autosomal dominant; at least 2 of the following features: * Ash leaf spots (hypopigmented lesions; seen w/ Woods lamp; need 3 on the body) * Shagreen patch (hyperpigmented plaque, rough/thick & papular) * Angiofibromas (look like acne, spares the forehead) * periventricular or cortical tubers (infantile spasms or seizures) * Cardiac rhabdomyomas (arrhythmias) * Renal angiomyolipoma

**What is this seen in?**

**Neurofibromatosis 1 (NF1)** ## Footnote * autosomal dominant; need at least 2 of the following: * 1st degree relative with the disease * neurofibromas * lisch nodules in the iris * optic nerve gliomas * 6 regular cafe-au-lait macules * scoliosis * axillary or inguinal freckling

**What is this?**

**Molluscum Contagiosum** ## Footnote * flesh-colored, pearly papules that are dome-shaped and umbilicated. * caused by pox virus * no treatment needed * may use cryotherapy or topical cantharidin, podophyllotoxin, imiquimod, or potassium hydroxide.

**What type of rash is this?**

**Pitted Keratolysis** * pitted skin in areas of pressure * history of strong foot odor

**What type of rash is this?**

**Papular Urticaria** ## Footnote * due to hypersensitivities to the insect bites (bedbugs, fleas, mosquitos) * pruritic * recurrent crops * some lesions may be umbilicated

**What type of rash is this?**

**Allergic Contact Dermatitis** ## Footnote **Nickel Allergy** * Type IV Hypersensitivity reaction * requires a prior exposure * rash may present even after years of wearing the irritant

**What is this due to?**

**Trichotillomania** * a body-focused repetitive behavior in which patients pull out their hair. (This may be on a location other than the scalp.) * loss of hair in an irregular pattern (not a nice circle). * the irregularly shaped patches will contain incomplete hair loss in which you will see hair of differing lengths.

**What type of rash is this?**

**Seborrheic Dermatitis** ## Footnote **(Cradle Cap)** * non-pruritic * treat with topical antifungal or mild steroids * hypopigmented areas = PITYRIASIS ALBA

**What is this?**

**Staph Scalded Skin Syndrome** * due to exotoxin * very painful and red rash * sheet-like skin loss/separation (superficial) * biopsy to prove SSS and not SJS or TEN * lesions are NOT in the eyes or mouth, but around it

**What is this?**

**Tinea Capitis** ## Footnote **AKA Ringworm** * broken hair that looks like “black dot alopecia.” * There is often inflammation * can be associated with a kerion (a raised spongy lesion). * Treat with GRISEOFULVIN. * You do not need any baseline labs.

**What type of rash is this?**

**Guttate Psoriasis** ## Footnote * "drop like" * can be preceded by a Group A strep infection

**What is this?**

**Nevus Flemmeus** ## Footnote **Port Wine Stain** * capillary malformations * unilateral and segmental; not crossing the midline * present at birth and are PERMANENT * benign if noted in isolation * if on the face, can be associated with glaucoma * seen in Sturge Webber Syndrome

**What is this?**

**Herpetic Whitlow** ## Footnote * caused by HSV-1 * very painful infection of thumb or finger

**What is this?**

**Hemangioma** ## Footnote * an abnormal build up of blood vessels * eventually self-involute * dangerous during proliferation phase (greastest during 1st 6 months) * start to involute around 2 yrs of age * dissapear by 5-10 yrs of age * Treat: Propanolol, steroids or laser (sensitive areas)

**What is this?**

**Peg Teeth** ## Footnote * they are tapered and look like fangs * usually affected the lateral incisors * associated with INCONTINENTIA PIGMENTI and HYPOHYDROTIC ECTODERMAL DYSPLASIA

**What type of rash is this?**

**Lichen Striatus** ## Footnote * looks like eczema * linear or papular * can follow the lines of blaschko

**Where is this seen?**

**Scleroderma** ## Footnote * thickened skin with an ivory or waxy appearance * girls more frequently affected * limited form is more common in children than the systemic form * lesions may initially be painful and tender * Treat: topical (limited cases); steroids or immunosuppressives (severe cases)

**What is this?**

**Apthous Ulcer** * painful lesions found within the oral mucosa * grayish-white base and a rim of erythema * can occur in isolation or in association with Behcet's or Shwachman-Diamond syndrome

**What type of rash is this?**

**Dermatomyositis** ## Footnote **Gottron's papules** * heliotropic, violaceous rash in malar area * telangiectasias near the nail folds * proximal muscle weakness * Diagnosis: Muscle biopsy * Elevated CK

**What is this?**

**Condyloma Lata** ## Footnote * found in secondary syphilis * White-gray, coalescing papules * appear much more FLAT than Condyloma Acuminata

**What is this?**

**Herpes Gingivostomatitis** ## Footnote * caused by HSV-1 * oral and perioral/vermillion border lesions/vesicles. * gingiva is friable and malodorous. * lymphadenopathy

**What rash is this? Baby is 3 months old...**

**Infantile Acne** ## Footnote * looks like typical pubertal acne, but it is found in babies. * Onset is usually around 2–3 months of age * due to androgenic stimulation. * There can be COMEDONES (whiteheads and blackheads). * can resolve in a few weeks or it can take up to a year to resolve.

**What disorder is this?**

**Hypohidrotic Ectodermal Dysplasia** * related to INCONTINENTIA PIGMENTI (X-linked dominant); but can occur in boys * hypohydrosis (decreased sweating) * hyperthermia * hypotrichosis (sparse hair) * no eyelashes/lashes * delayed tooth eruption * deformed/peg teeth

**What disorder is this?**

**Arthrogryposis Multiplex** ## Footnote * due to idiopathic fetal akinesia (decreased fetal movement). * contractures

**What do they have?**

**Kwashiorkor** * Kwashiorkor is a complex, multi-system disease caused largely by PROTEIN DEFICIENCY. * These children have pitting edema, large abdomens, hepatomegaly, and can have an associated rash.

**What is this nutritional deficiency called?**

**Marasmus** * deficiency of all nutrients. * These children do NOT have edema. * They are thin, anorexic-looking children with severe muscle wasting. * The patient looks like a thin, old man.

**What syndrome does he have?** a child with LIVER and HEART disease

**Allagille Syndrome** **AKA Arteriohepatic Dysplasia** * a genetic disorder in which jaundice is noted in the newborn period. * Here are some associations: * paucity of bile ducts (AKA intrahepatic biliary atresia or hypoplastic biliary ducts) * pulmonary stenosis, * a triangular face (underdeveloped mandible → small, pointed chin), * Tetralogy of Fallot, * hypercholesterolemia with xanthomas, * eye abnormalities, * acholic stools.

**What disease is this abnormality seen in?**

**Wilson's Disease** **Kayser-Fleischer ring** * autosomal recessive disorder resulting in excess copper accumulation, especially within the liver and brain. * Accumulation in the liver can lead to hepatomegaly, spider nevi, esophageal varices, and a Coombs-negative hemolytic anemia. * Accumulation in the brain can lead to neurologic changes including tremors, poor school performance, ataxia, abnormal eye movements, and spasms. * On eye exam, a Kayser-Fleischer ring may be visible. * Copper levels are low in the serum but high in the tissues. * Diagnose by LIVER BIOPSY. * Treat with PENICILLAMINE, a copper chelator.

**What is this?**

**Hordeolum (Stye)** ## Footnote A hordeolum (AKA stye) is a red and painful eye lesion noted at the rim of the eyelid (near the eyelashes). Prescribe warm compresses and possibly topical antibiotics as well. PEARL: Do NOT prescribe oral antibiotics.

**What is this slow growing lesion called?**

**Chalazion** A chalazion is a much slower-growing, painless lesion that results from inflammation of the meibomian gland. There can be erythema as well, but it is much less painful. It resolves on its own, and warm compresses do not help. PEARL: Ophthalmology should be involved if it is chronic or interferes with a patient’s vision.

**What is this eye condition?**

**Hyphema** Hyphema is a condition in which blood is present in the anterior chamber. Look for blood pooling at the bottom of the iris. If it is small and due to trauma, you may have the patient follow up with ophthalmology. If it is large, consider monitoring in the hospital and keeping the patient’s bed at a 45° angle. There is a danger of developing glaucoma (increased intraocular pressure).

**What does this patient have?**

**Papilledema** ## Footnote Papilledema is swelling of the optic disc. The patient’s vision is usually not affected until there has been significant progression, so do NOT rule this out if the patient’s vision is 20/20. On exam, they will have loss of venous pulsations, blurring of the optic disc margins, and may have a bigger than usual blind spot. PEARL: Papilledema is due to increased intracranial pressure, and is therefore a bilateral phenomenon. If you are given a patient with unilateral abnormalities, consider a different choice.

**What eye finding does this baby have?**

**Strabismus** Strabismus basically means there is improper alignment of the eyes. It could be associated with an esotropia (eye looks more inward/medially) or an exotropia (eye looks more outward/laterally). **Pseudostrabismus** is the appearance of strabismus, or being “cross-eyed,” even though the alignment of both eyes is appropriate. This is often seen in patients with prominent, or uneven, epicanthal folds.

**What type of strabismus does this boy have?**

**Esotropia** ## Footnote Esotropia is an inward deviation of the eye. This is common **up until 3 months of age**, but it’s abnormal after that. Esotropia can be unilateral or bilateral. If the right eye is staring at you and has a centered red light reflex while the left eye is deviated more inward, the left eye has the esotropia and is likely to have a light reflex that seems laterally displaced in comparison to the center of the pupil. The left eye is at risk for developing amblyopia. Treat by applying a patch to the “strong” right eye.

**What kind of tumor is this?**

**Osteosarcoma** This is usually at the proximal or distal aspect of the long bones. Look for a long bone with a SUNBURST PATTERN/LESION. PEARLS: This may present as a teen going through a GROWTH SPURT and having UNILATERAL bone pain (GROWING PAINS should be bilateral, at night, better with NSAIDS and without edema). It may also present as post-traumatic pain that actually gets worse instead of getting better.

**What kind of tumor is this?**

**Ewing Sarcoma** Look for a long bone with lamellated “ONION SKIN” lesions. These lesions look like a very thin extra layer of bone, or like a thin onion peel lying over the bone. They can also have a SUNBURST pattern similar to osteogenic sarcomas. Ewing sarcoma may affect the pelvic bones and soft tissues as well. Lesions are extremely painful.

**What kind of tumor is this?**

**Osteochondroma** Osteochondroma is a very common and BENIGN bony tumor that is usually located near GROWTH PLATES. The bony tumor has a cartilaginous cap.

**What is this bone condition called?**

**Osteoid Osteoma** The osteoid osteoma description sounds a lot like “growing pains.” It is BENIGN, worse at night, and RELIEVED BY ASA. The distinguishing feature is that it is UNILATERAL. X-rays will show a central radiolucency with thickened bone around it.

**What malignancy this child have?**

**Retinoblastoma** ## Footnote The primary finding for retinoblastoma is LEUKOCORIA. There is increased risk of osteogenic sarcoma (AKA osteosarcoma) of a long bone in the future. The inheritance pattern is actually a little confusing, with there being a strong genetic component but also a high rate of spontaneous mutations. PEARLS: Avoid completely discounting this disorder just because there is no family history. Retinoblastoma is a prime example of a disorder that often occurs due to spontaneous mutations. If you are given information about chromosome 13 and an eye problem, or if you are given the X-ray of a long bone (such as a femur, tibia, humerus, radius, or ulna), consider this diagnosis.

Pediatric Pictures Flashcards

(94 cards)