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- W157637786 abstract "A 5½-year-old girl was brought to us for medical assessment because of a history of menarche at the age of 4 years and bilateral lower limb pain for a 12-month period. Historically, she had been born at term to nonconsanguineous parents. She had no previous medical illnesses and no prior history of use of any medications. Physical examination revealed a girl with normal stature (height SD score of +1.3, based on Western data) and normotension, who had a large pigmented skin lesion in the right T4 and T5 dermatome area (Fig. 1). She had a genu valgum with an intermalleolar distance of 3 cm and no other bony swellings or deformities. There was evidence of early thelarche (breast, Tanner stage 2) but no evidence of adrenarche. Systemic examination showed normal findings. Results of laboratory tests were as follows (normal ranges shown parenthetically): serum estradiol <0.07 nmol/L (luteal phase in women, 0.1 to 0.91), serum luteinizing hormone <0.10 mIU/mL (luteal phase in women, 0.0 to 14.7), serum folliclestimulating hormone 0.81 mIU/mL (luteal phase in women, 1.2 to 9.0), and serum thyrotropin 1.47 μIU/mL (0.3 to 4.5). Serum calcium and phosphorus levels as well as liver and renal function tests were normal. X-ray examination of the wrists (Fig. 2) showed cystic lesions in the metacarpal bones in conjunction with advancement of the bone age by 3½ years. X-ray examination of the tibia also revealed an early expansile cystic lesion (Fig. 3). What is the diagnosis? Fig. 2 View Large Image Figure Viewer Fig. 3 View Large Image Figure Viewer" @default.
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- W157637786 date "2007-01-01" @default.
- W157637786 modified "2023-09-25" @default.
- W157637786 title "Visual Vignette" @default.
- W157637786 doi "https://doi.org/10.4158/ep.13.2.205" @default.
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