RT Journal
A1 Riepe FG, Eichmann D, Oppermann HC, Schmitt HJ, Tunnessen WW, Jr
T1 PIcture of the month
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2001
FD May 1
VO 155
IS 5
SP 607
OP 608
DO 10.1001/archpedi.155.5.607
UL http://dx.doi.org/10.1001/archpedi.155.5.607
AB 
A 15-MONTH-OLD boy had a history of unexplained bleeding from his gums for several weeks and fever for 2 days. He had been fed only cow's milk and oatmeal since age 4 months. On physical examination he had almost no spontaneous movement. His legs were held in a "frog leg" position (Figure 1), were swollen along the long bones, and were tender to palpation. His skin was dry and pale. Hemorrhages of the gingiva were obvious as were 2 blood-filled cysts of the lower canine teeth (Figure 2). The tympanic membranes were hyperemic, and evidence of middle-ear fluid was present. Palpable prominence of the costochondral junctions of the chest wall was noted.