Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Pediatric Medicine


Answer 5
  1. Bone age determination. Premature thelarche, or the isolated onset of breast development, is most commonly seen before age 4 years in girls. Although this finding can represent the beginning of precocious puberty, puberty in most affected girls does not progress, and the remainder of pubertal development occurs at a normal age. Although the majority of cases are idiopathic, an assessment of whether the child has ingested any estrogen-containing medication can occasionally reveal a potential cause. A bone age determination will help rule out accelerated growth that may be associated with more serious conditions. Pelvic examination and breast biopsy are contraindicated-pelvic examination because of the potential trauma involved (pelvic ultrasound may be considered if indicated) and biopsy because of the potential damage to the breast bud which could prevent future breast development. Luteinizing hormone level is generally normal in these patients, although an elevated follicle-stimulating hormone level is occasionally seen. Karyotype analysis is not generally useful in determining the diagnosis.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj