We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Radiological Case of the Month FREE

Gary Schwartz, MD
[+] Author Affiliations

Section Editor: Beverly P. Wood, MD

Arch Pediatr Adolesc Med. 1998;152(5):503-504. doi:10.1001/archpedi.152.5.503.
Text Size: A A A
Published online

A 15-YEAR-OLD girl presented with a 2-hour history of severe abdominal pain. The pain was located in the left lower quadrant and was not initially associated with nausea and vomiting. It was neither relieved nor aggravated with movement. She reported similar pain several months earlier, with rapid spontaneous resolution. That episode was considered to be related to a renal stone, but no further testing was performed because she was symptom free at the time of the office visit. She had no history of urinary symptoms.

There was no notable medical history and her last menstrual period was 1 week prior to this presentation.

Physical examination indicated she was afebrile with normal vital signs; however, she was writhing in pain. Bowel sounds were normal and there was no rebound tenderness and no organomegaly. The rectal examination did not reveal a mass or blood.

Laboratory data included a negative pregnancy test result and normal findings from urine analysis. The white blood cell count was 8.1×109/L. An abdominal radiograph (Figure 1) and pelvic ultrasonographic scans (Figure 2) were obtained.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

5 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Radiographic and Anatomic LSS

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis