TY - JOUR T1 - Think back JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 199 LP - 199 DO - 10.1136/archdischild-2015-309308 VL - 101 IS - 4 AU - Steven McVea AU - Lynne McFetridge AU - Jarlath McAloon Y1 - 2016/08/01 UR - http://ep.bmj.com/content/101/4/199.abstract N2 - An 11-year-old girl presented to the emergency department with a week of generalised abdominal pain, anorexia and reduced stooling. The pain did not disturb sleep, and there was no associated weight loss, urinary symptoms or gastrointestinal bleeding. Examination suggested constipation, and an abdominal radiograph (AXR) was performed (figure 1).Figure 1 Abdominal radiograph.1. What does figure 1 show? Normal radiographFaecal impactionSkeletal abnormalityRenal calculiBowel obstructionMovicol was started, and the patient was discharged. Two further assessments for abdominal pain were sought in the next fortnight. No further investigations were ordered, and there was no change to management.Three weeks from the original presentation, she developed leg pain and inability to weight-bear. No urinary symptoms were present. Lower limb examination revealed increased tone with extensor plantars bilaterally. A tender posterior … ER -