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Child Abuse Case 2


This 12-year-old girl, born in Puerto Rico, was seen for well-child care. Her pediatrician referred her after a report was made to child protective services due to the finding on her shoulders. These painless and slightly raised marks were noted on both shoulders. Her previous medical care had been provided in her home country until the age of 12. At the 11-year-old visit, there was no documentation regarding these marks. The girl states that she noticed them a few months ago and does not know how she got them. She was at the 50th percentile for height and weight one year ago, but now is at the 90th percentile.


Case 2

Source: A. S. Botash, MD, used with permission


Which of the following statements is true regarding these marks?

  1. Rapid growth during or prior to adolescence is common prior to development of this finding.
  2. Obesity is a risk factor.
  3. Use of weights for bodybuilding is associated with this finding.
  4. All of the above.

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