TY - JOUR T1 - An unusual cause of chest pain in a teenage girl JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed DO - 10.1136/archdischild-2016-312557 SP - edpract-2016-312557 AU - Ben McNaughten AU - Andrew Thompson AU - Dara O'Donoghue Y1 - 2017/03/16 UR - http://ep.bmj.com/content/early/2017/03/16/archdischild-2016-312557.abstract N2 - A 13-year-old girl presented with a 3-day history of worsening paroxysmal cough and vomiting. She also described chest pain over the preceding 3 weeks. These acute symptoms occurred on a background of cough, dyspnoea and weight loss over a 2-month period. She had no significant past medical history. On examination, she was afebrile, pale and lethargic. Her respiratory rate was 22 breaths/min , oxygen saturations were 91% in room air and heart rate was 88 beats/min. Air entry was good throughout and there was no wheeze on auscultation. A chest X-ray performed 1 month previously was normal. A repeat chest X-ray was requested (figure 1).Figure 1 Chest X-ray on admission. What abnormalities are visible on the chest X-ray?What is the most likely diagnosis? AsthmaGastro-oesophageal reflux diseaseInfectionMalignancyMetabolic bone disease … ER -