Author: Daniel Murrell / Editor: Martin Dore / Codes: / Published: 05/03/2019
A 4 year old girl presents to the Emergency Department with a two day history of inconsolable crying, inability to sleep at night, fever and inability to weight bear.
There is no history of recent illness, trauma or travel. She has no relevant medical history. She was born at term with no neonatal complications, and has a normal growth and development. Immunisations are up to date.
On examination she has normal observations, looks systemically well, but is in severe distress when trying to stand. You note she has point tenderness in the midline over her lumbar spine.
