RT Journal A1 Posner KR, Friedlaender E T1 PIcture of the month—quiz case JF Archives of Pediatrics & Adolescent Medicine JO Archives of Pediatrics & Adolescent Medicine YR 2011 FD January 1 VO 165 IS 1 SP 85 OP 86 DO 10.1001/archpediatrics.2010.265-a UL http://dx.doi.org/10.1001/archpediatrics.2010.265-a AB Results of her physical examination revealed a soft, tympanitic, mildly distended abdomen, tenderness in the lower quadrants, and a palpable, painful mass in the right lower quadrant. She had voluntary guarding but no rebound. The remainder of the examination was unremarkable. A plain radiograph of the abdomen was obtained (Figure).