Differential Diagnosis
Abdominal Mass
The clinical classification of abdominal masses in children can be divided according to neonatal and postneonatal causes. Approximately one half of abdominal masses in newborns involve the urinary tract. Constipation is the most common cause of an abdominal mass in the older child.
Abdominal Pain
Abdominal pain is any abdominal discomfort that may be acute or chronic, constant or intermittent, sudden or insidious. It may or may not be associated with other gastrointestinal (e.g., diarrhea, vomiting), genitourinary (e.g., dysuria, discharge, menorrhagia), infectious (e.g., fever, sore throat, headache, malaise), or systemic (e.g., lethargy, irritability, rash) findings.
Chronic
Common, general
Alopecia/Hair Loss
Alopecia refers to hair loss from the scalp. The differential diagnosis deals with acute causes of alopecia.
Altered Mental Status
Altered mental status includes several different states of consciousness. Delirium is confusion and irrational behavior that is sometimes accompanied by excitability. Lethargy refers to sleepiness and disinterest in the environment. Stupor or obtundation refers to a state of unconsciousness from which a child can momentarily be aroused. Coma is a prolonged state of unconsciousness.
Amenorrhea
Amenorrhea is the absence of menses. Primary amenorrhea is defined as the absence of menarche by age 16 years in the presence of normal pubertal development or the absence of menarche by age 14 years in the absence of normal pubertal development or the absence of menarche 2 years after completion of sexual maturation. Secondary amenorrhea is defined as the absence of menstruation for at least three cycles or at least 6 months in females who have already established menstruation. It is helpful to divide the evaluation of amenorrhea into three categories: amenorrhea with normal pubertal development, amenorrhea with delayed pubertal development, and amenorrhea with abnormal genital examination findings.
Anemia
Anemia is a reduction in the number of red blood cells (RBC) or a low hemoglobin concentration. Anemia can be microcytic (small RBCs, low MCV), normocytic, or macrocytic (large RBCs, high MCV).
Arthritis
Arthritis is defined as swelling of a joint that is accompanied by limitation of motion, heat, pain, or tenderness. Arthralgia refers to pain or tenderness of a joint alone.
Infectious or postinfectious causes
Ataxia
Ataxia refers to impairment in coordination of movement without loss of muscle strength.
Back Pain
Back pain is less common in children than in adults. In general, the younger the child, the more likely back pain signifies serious pathology.
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