human
(Pediatrics) 24 month old white female with discordant bone age. 31" tall, 21 pounds. No meds, no surgeries.(Pediatrics) 24 month old white female with possible short stature. 31" tall, 21 pounds. No meds, no surgeries.My 2 year old hasn't been getting very tall as she's gotten older. She's dropped to the first percentile for height. Her first pediatrician wasn't overly concerned, but we saw a new pediatrician and she was concerned and had her x-rayed. I got the report back, but the doctor is out of the office so I won't be able to talk to her until next week.The radiology report says:FINDINGS: A single radiograph of the hand was provided for evaluation of bone age. The patient's chronological age is 24 months. The hand bone age according to the tables of Greulich and Pyle is approximately 2 years. The wrist bone age most closely approaches that of 1 year and 3 months. The standard deviation for the patient's chronological age is 4.64 months. No structural abnormalities are identified.IMPRESSION:Discordant bone age between the hand and wrist, but both are within 2 standard deviations of chronological age per the age and gender matched standards of Greulich and Pyle.Is the discrepancy worrisome?https://flic.kr/p/2nS9y6S
gpt
Worrisome probably isnt the right term. It isnt indicative of anything dangerous.It can sometimes indicate a hormonal issue that requires endocrine referral.But will also say that pediatric endocrinologists and radiologist often disagree on bone ages.Bone ages are pretty subjective. Basically they x-ray the hand in a specific way and then compare it to a book with known bone ages and say eh, I think it looks like this one the most.
Is antibiotic resistance some thing I have to worry about?I have a daughter who is four years old. She has no pertinent or obvious health problems, except for a lingering cough she had for about eight months after we had Covid last year. She is almost 4 feet tall and about 55 pounds. She has been having recurring vaginal discharge for over a year now. She has been on amoxicillin, Cefdinir, and keflex. Finally, after so long of not having any answers, they finally sent her to a pediatric gynecologist. She did an internal swab and found the strep bacteria. But, after a phone call with her, she told me that all of the antibiotics she has taken so far should have killed the bacteria. Each time she took antibiotics it was for 10 days.She prescribed her another, fourth kind of antibiotic, and said that if this doesnt kill it, that she will have to have a check up inside her vagina under sedation. I am not against this procedure, but now I have become a little worried about antibiotic resistance. If these previous antibiotics were supposed to kill the bacteria and she took them for 10 days, is this a bad sign? Or is it really possible that these three different kinds of antibiotics that she took for 10 days each didnt really kill the bacteria? Id love another doctors opinion on the matter.
It's probably fine.It's not clear to me she has an infection that needs antibiotics.