IUGR and fetal malnutrition

Newborn babies with IUGR often appear thin, pale, and have loose, dry skin. The umbilical cord is often thin and dull-looking rather than shiny and fat. Babies with IUGR sometimes have a wide-eyed look. Some babies do not have this malnourished appearance but are small all-over.1

In FM, the subcutaneous tissues and underlying muscles are diminished and the skin of arms, legs, elbows, knees and interscapular regions is very loose. In severe FM, the neonate may look “emaciated” or “marasmic” as the skin appears “several sizes” too large for the baby.2

such horizontal peeling skin lines are very often seen in IUGR babies and that reflects the growth failure especially in the third trimester.

http://www.peditips.com/when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

rheumatic nodules

rheumatic nodules: one of the rare manifestations of rheumatic fever a major sign of acute rheumatic fever. the swelling on forearm and back are easy to make out. this was a 10 yr old boy with mitral regurgitation with acute rheumatic fever. for our surprise this child also had chorea , carditis joint pains and rheumatic nodules. may be we were not that expert to pick up the transient erythema marginatum.



rheumatic nodules can come in crops, various sizes rounded subcutaneus bulges on extensor aspects of body. This patient had them even on scalp and forehead. Although they range from sizes 1 cm to 10 cm in diameter; even they may be just solitary, however this patient had more than 50 nodules.



These theumatic nodules disappeared in 10-15 days after treatment along with settling of clinical features.

rheumatic nodules

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when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

scabies lesions on trunk, in chronic dermatitis form

scabies lesions on trunk, in chronic dermatitis form

refer last post for more scabies lesions

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when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

infantile scabies scabies in infant vulgar scabies norwegian scabies von vagabonds disease

infantile scabies scabies in infant vulgar scabies norwegian scabies von vagabonds disease

These are the burroughs of the itch mite scabies the sarcoptes scabei.

spreads due to overcrowding poor hygiene and skin to skin contact.

look for these pimple burroughs usually not on palms and soles as seen here but in the webspaces. It can come at palm sole and elsewhere mainly in immunocpomromised cases. Usually a second case or contact is surely there in family/mother/school .

good and complete treatment gives 100% cure.

The best way to treat is the medicine that stood in the course of time. that is benyl benzoate lotion. C6 H6 Cl6

Apply the lotion in all areas and allover body except above neck.

apply it on 3 consequtive nights before sleep and wash with bath.

wash all clothes and linen in warm water.

Treat all contacts.

Trim nails and keep hyegiene at home.

repeat same3 for 3 weeks.

Infected scabies will require antibiotics.

eMedicine - Scabies : Article by William D Binder, MD
Scabies - Scabies is a common parasitic infection of global proportion. Worldwide, an estimated 300 million cases occur annually www.emedicine.com/emerg/topic517.htm

Division of Parasitic Diseases - Scabies Fact Sheet - 3:51am
Scabies is an infestation of the skin with the microscopic mite Sarcoptes scabei. Infestation is common, found worldwide, and affects people of all races ... www.cdc.gov/ncidod/dpd/parasites/scabies/factsht_scabies.htm

www.peditips.com when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

Don't Freak Out About Epilepsy

Don't Freak Out About Epilepsy

enlarged adenoids adenoiditis

can you see the area between two stars marked in the image?
normally the posterior wall of nasopharunx is concave. any convexity along the posterior wall suggests a mass / abscess or adenoids.
this is adenoids as it is in the area just above or along the level of palate. they are enlarged in adenoiditis.

one can also appreciate the airway narrowing of the nasopharynx.
adenoids usually present with persistant rhinorhea hypernasal speech not able to pronounce R and mouth breathing with face turned up, with or without nose tip turned up.
medical treatment is with soothing comfort and decongestants and nose drainage. chronic adenoiditis requires surgical resection called as TAR surgery to get symptomatic relief.
SOme of these children have obstructive sleep apnea syndrome. (OSAS)

www.peditips.comwhen a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

please see the last post for description of adenoiditis

please see the last post for description of adenoiditis

these images are in continuation with last post.

www.peditips.comwhen a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

cervical lymh nodes, jugulodigastric node

Lymph nodes in neck in toddler age group are very common. they commonly follow a throat infection. they can be an early marker of tuberculosis of tonsillar origin. its a sign of throat infection which is better examined when the mouth is closed.

As in this child, se the bulge seen below the mandible on right side. That is a palpable and visible (so significantly enlarged) cervical node.

Usually cervical nodes when larger than 1.5 cm size in children are called significant.

if the child is having active throat symptoms ( like in acute stage the throat may be congested. if its chronic the child may be coughinf since days), he may benefit by symptomatic therapy and a course of antibiotics for 10 days before ruling out TB, TB will be more likely if the lymphadenopathy is multiple / matted and Matoux test is positive.

www.peditips.com

when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

infant of diabetic mother

The plethora on the face, and the yellowish hue to the pink cherubic cheeks, in a newborn who is little overweight; yes; u r surely dealing with an infant of a diabetic mother. This may be due to polycythemia.

they are likely to born by a caserean section as they have macrosomia in 26% cases. These are mostly LGA babies and may suffer from hypoglycemia.

Major congenital malformations are found in 5-9% of affected infants and account for 30-50% of perinatal deaths of infants of mothers with gestational diabetes. **

www.peditips.com

when a doctor completes his training without the real hands on experience, its mistaken by many that what you are taught in medical school is totally in contrast with what you see clinically in patients. This blog aims at making medical students and docs understand how every case is exactly the same as in books. The work done by senior docs over the years is really rewarding. Infact when one finds a contrast in what is taught, he should go to books and you will find the exact descriptions verbatim, or the images as they are explained in medical books.

unerupted molar teeth

Dentition rules:

1. for every 6 months of life, approximately 4 teeth will erupt.
2. Girls generally precede boys
3. Lower teeth usually erupt before upper teeth
4. erupt in pairs
5. Primary teeth are called milk teeth small and white.
6. By to 3 years of age, all primary teeth should have erupted
7. Canines will always erupt second last.
8. Primary teeth erupt in 6-7-8-9 month formula while secondary teeth by respective years.
9. dentition can be delayed due to many causes like rickets.
10. Causes of delayed tooth eruption
    Endocrine disorders
    Hypothyroidism
    Calcium/phosphorus metabolism problems
    Hypopituitarism
    Genetic disorders and bone disorders
    Ectodermal dysplasias
    Down syndrome
    Cleidocranial dysplasia
    Gaucher disease
    Osteoporosis
    Local factors
    Tooth in path of erupting tooth, insufficient space, impacted teeth
    Dental infection
    Radiation therapy

http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp;jsessionid=G1Y4rsYBGKyRy6pPryj91JcjTP50Lc0hpDh1Z6GTKPvJ5CDRx9Zh!-433246586?id=110077

occipital hemangioma, scalp hemangioma

Hemangiomas are the most common (benign) tumours of infancy.

Face and scalp are common areas. facial hemangiomas are more prone for disfigurement with age.

This is a superficial hemangioma. Deep hemangiomas are usually smooth and nodular.

Characteristics of PHACE(S) syndrome
P osterior fossa brain malformations, most commonly of the Dandy-Walker variant

H emangiomas (especially large, segmental facial lesions)

A rterial anomalies

C ardiac anomalies and coarctation of the aorta

E ye abnormalities

S ternal cleft, supraumbilical raphe, or both

JULY 2003 / POSTGRADUATE MEDICINE ,

IJDVL Year : 1999 Volume : 65 Issue : 2 Page : 99-103

Facial hemangiomas may be a part of Sturge-Weber syndrome.

Ghon's complex

Ghon's complex

it is also known as primary complex of TB. It is formed by primary Tb focus at the lower part of upper lobe and upper part of middle lobe, usually on right side. This primary focus is a parenchymal opacity. this primary focus along with its lymphatics and draining lymph node is called preimary complex or Ghon complex or Ghon's complex.

In this x ray you may see the somewhat homogenous opacity in the Ghon's area on right side of sternum can represent the Ghon's complex pneumonia.

airway Xray neck lateral

a lateral xray of neck is very often asked for the soft tissue shadows when one suspects adenoids, para or retropharyngeal abscess and or a space occupying lesion in neck including cysts and others.

It surely does depict spine very details but for for visualisation of dense one asks for xray AP with open mouth.

For better delineation of airways, the patinet is asked to keep mouth slightly open, and neck slighlt extended, as in this xray. Air gives contrast with soft tissue shadows making many pathologies obvious.

This normal airway lateral x ray depicts nasopharynx, tongue, mandible, glosoepiglottic recess, epiglottis and larungeal sca clearly. you can also see the body of hyoid bone. Ant convexities bulging in the airway will make u suspect about an abscess.

mediastinal lymph node TB

Its very easy at times and at times too difficult to logically outline a probable lymph node shadow on a X ray chest.

In the image on right, you can see a bean shaped right mediastinal lymph node.

The presence of these shadows is always required to be confirmed by a lateral Xray chest and / or a chest Ct scan.

Presence of these solitary or multiple nodes usually suggests tuberculosis, but can be an early sign of lymphoma or other chronic granulomatous diseases and HIV.

Lymph node TB is a commonest form of TB in school age children. the diagnosis however may be supported by a Matoux test and TB contact and / or other clinical features.

double malleoli sign of rickets

As we all know there is osteoid hyperplasia at metaphysis due to decreased mineralisation of bone resulting from calcium and vitamin D deficiency.

This gives rise to two swellings along the medial malleolus, the lower one is medial malleolus and upper one is the metaphysial widening.

This is called double malleoli sign of rickets.

this is medical images newsletter

this is medical images newsletter

periodically updated by Dr Kondekar santosh venketraman
http://drpeds.blogspot.com
http://peditips.blogspot.com
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