Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis PDF
Preview Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis
ZITELLI AND DAVIS’ A T L A S O F PEDIATRIC PHYSICAL DIAGNOSIS ZITELLI AND DAVIS’ A T L A S O F PEDIATRIC PHYSICAL DIAGNOSIS SEVENTH EDITION BASIL J. ZITELLI, MD Professor of Pediatrics University of Pittsburgh School of Medicine Director The Paul C. Gaffney Diagnostic Referral Service Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania SARA C. McINTIRE, MD Professor of Pediatrics University of Pittsburgh School of Medicine Advisory Dean Office of Student Affairs Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania ANDREW J. NOWALK, MD, PhD Assistant Professor of Pediatrics University of Pittsburgh School of Medicine Pediatric Infectious Disease Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania IN MEMORIUM Holly W. Davis, MD ambulatory chief resident. In 1978 she became the medical director August 23, 1945–September 6, 2013 of the Emergency Department. Her focus on children led to an invitation to “Mr. Rogers’ Neighborhood” television program to We miss Holly Davis. Holly W. Davis, explain to children in the audience what to expect and how they MD, an original co-editor and con- would be cared for in the Emergency Department. She reassured tributor to the Atlas, passed away in children and parents that we “had a lot of different ways in which 2013 after battling cancer. Holly we help children get better.” She spearheaded the construction of a helped to develop the concept of the new Emergency Department with innovative ideas emulated by Atlas and worked tirelessly with con- many institutions around the country. In 1999 Holly became co- tributors over 6 editions to shape the director of the Child Advocacy Center until her retirement in 2005. style, provide clinical images and She became well-known for her skill in evaluation and detection of assure the quality of the textbook. abuse and neglect in children. She was a fierce advocate for these Holly was a consummate clini- children. cian–educator. She was widely respected not only for her diagnostic Holly Davis was an accomplished pediatrician, respected clini- and clinical acumen, but also for her boundless energy, enthusiasm cian, teacher, mentor, colleague and friend. But even more, Holly and focus on the child and family. loved teaching, loved children and loved life. We were fortunate Holly attended Duke University for undergraduate school and to know Holly, work with her and honored to call her friend. We graduated from its medical school in 1971. She completed pediatric miss her. residency at Children’s Hospital of Pittsburgh and went on to become v 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 ZITELLI AND DAVIS’ ATLAS OF PEDIATRIC PHYSICAL ISBN: 978-0-323-39303-4 DIAGNOSIS, SEVENTH EDITION Copyright © 2018 by Elsevier, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 1987, 1992, 1997, 2002, 2007, and 2012. International Standard Book Number: 978-0-323-39303-4 Executive Content Strategist: Kate Dimock Senior Content Development Specialist: Joanie Milnes Publishing Services Manager: Julie Eddy Senior Project Manager: Marquita Parker Designer: Brian Salisbury Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 CONTRIBUTORS Wael Abdel Kawy Abdalla, MD, MSc Elaine Cassidy, MD Assistant Professor Assistant Professor of Pediatrics Department of Radiology Division of Pediatric Rheumatology Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Vivek Allada, MD Diego Chaves-Gnecco, MD, MPH, FAAP Associate Professor of Pediatrics Assistant Professor of Pediatrics University of Pittsburgh School of Medicine University of Pittsburgh School of Medicine Clinical Director SALUD PARA NINOS Program Director and Founder Pediatric Cardiology, Heart Center Developmental-Behavioral Pediatrics Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Georgianne Arnold, MD Wassim Chemaitilly, MD Professor of Pediatrics Assistant Professor of Pediatrics University of Pittsburgh School of Medicine Division Director Children’s Hospital of Pittsburgh of UPMC Pediatric Endocrinology Pittsburgh, Pennsylvania St. Jude Children’s Research Hospital Memphis, Tennessee Arcangela Lattari Balest, MD Assistant Professor of Pediatrics Kenneth P. Cheng, MD Division of Newborn Medicine Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Wexford, Pennsylvania Pittsburgh, Pennsylvania David H. Chi, MD Heather Baumhardt, DDS Assistant Professor Clinical Assistant Professor University of Pittsburgh School of Medicine University of Pittsburgh School of Dental Medicine Director Pediatric Dentistry Hearing Center Children’s Hospital of Pittsburgh of UPMC Division of Pediatric Otolaryngology Pittsburgh, Pennsylvania Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Lee B. Beerman, MD Professor of Pediatrics Hey Jin Chong, MD, PhD University of Pittsburgh School of Medicine Assistant Professor of Pediatrics Division of Pediatric Cardiology Division of Pulmonary Medicine, Allergy & Immunology Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Debra L. Bogen, MD James D. Cooper, MD Associate Professor of Pediatrics and Psychiatry Assistant Professor of Pediatrics University of Pittsburgh School of Medicine University of Pittsburgh School of Medicine Division of General Academic Pediatrics Pediatric Hematology/Oncology/BMT Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Mary M. Carrasco, MD, MPH Alene D’Alesio, DMD Associate Clinical Professor of Pediatrics Clinical Assistant Professor University of Pittsburgh School of Medicine Pediatric Dentistry Director Children’s Hospital of Pittsburgh of UPMC International and Community Health Pittsburgh, Pennsylvania Mercy Children’s Medical Center Pediatrics Pittsburgh, Pennsylvania vii viii Contributors Vincent F. Deeney, MD Dena Hofkosh, MD Associate Professor Professor of Pediatrics Department of Orthopaedics University of Pittsburgh School of Medicine Residency Program Director Developmental-Behavioral Pediatrics Orthopaedic Surgery Children’s Hospital of Pittsburgh of UPMC University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Emily Joyce, MD Demetrius Ellis, MD Fellow in Pediatric Nephrology Professor of Pediatrics and Nephrology Department of Pediatrics University of Pittsburgh School of Medicine University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Aviva Katz, MD, MA, FACS, FAAP Oscar Escobar, MD Associate Professor of Surgery Associate Professor of Pediatrics University of Pittsburgh School of Medicine Division of Endocrinology Pittsburgh, Pennsylvania University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Jacqueline Kreutzer, MD, FACC, FSCAI Pittsburgh, Pennsylvania Associate Professor of Pediatrics University of Pittsburgh School of Medicine Heidi M. Feldman, MD, PhD Department of Pediatrics Ballinger-Swindells Professor Director Department of Pediatrics Cardiac Catheterization Laboratory Stanford University School of Medicine Pediatric Cardiology Stanford, California Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Jonathan D. Finder, MD Professor of Pediatrics Allyson Larkin, MD University of Pittsburgh School of Medicine Assistant Professor of Pediatrics Clinical Director Division of Allergy & Immunology Pediatric Pulmonary Medicine Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Joseph E. Losee, MD, FACS, FAAP Robin P. Gehris, MD Professor of Surgery and Pediatrics Chief University of Pittsburgh School of Medicine Pediatric Dermatologic Surgery Chief Department of Dermatology Division of Pediatric Plastic Surgery Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Jesse A. Goldstein, MD Suneeta Madan-Khetarpal, MD Assistant Professor Associate Professor of Pediatrics University of Pittsburgh School of Medicine Division of Medical Genetics University of Pittsburgh Medical Center Department of Pediatrics Pediatric Plastic and Reconstructive Surgery Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Brian Martin, DMD Todd Green, MD Clinical Assistant Professor Assistant Professor of Pediatrics University of Pittsburgh School of Dental Medicine University of Pittsburgh School of Medicine Chief Allergy and Immunology Division of Pediatric Dentistry Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Lorelei J. Grunwaldt, MD Andrew A. McCormick, MD Director Vascular Anomalies Center Assistant Professor of Pediatrics Director Brachial Plexus Clinic Department of Pediatrics Assistant Professor of Surgery Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Contributors ix Sara C. McIntire, MD Jeffrey A. Rudolph, MD Professor of Pediatrics Assistant Professor of Pediatrics University of Pittsburgh School of Medicine University of Pittsburgh School of Medicine Advisory Dean Division of Pediatric Gastroenterology Office of Student Affairs Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Heidi A. Stephany, MD Marian G. Michaels, MD, MPH Assistant Professor Professor of Pediatrics and Surgery Pediatric Urology University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Pediatric Infectious Diseases Pittsburgh, Pennsylvania University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Gina S. Sucato, MD, MPH Director, Adolescent Center Yosuke Miyashita, MD, MPH Kaiser Permanente Washington Health Research Institute Assistant Professor of Pediatrics Clinical Associate Professor of Pediatrics Department of Pediatrics University of Washington University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Sylvia Szentpetery, MD Pediatric Pulmonology Fellow Pamela J. Murray, MD, MPH Children’s Hospital of Pittsburgh of UPMC Adolescent Medicine Pittsburgh, Pennsylvania Section Chief Professor of Pediatrics West Virginia University School of Medicine Sameh Tadros, MD, MSc Morgantown, West Virginia Clinical Assistant Professor University of Pittsburgh School of Medicine Srikala Narayanan, MD Department of Radiology Clinical Instructor Children’s Hospital of Pittsburgh of UPMC Department of Radiology Pittsburgh, Pennsylvania Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Jean M. Tersak, MD Assistant Professor of Pediatrics Andrew J. Nowalk, MD University of Pittsburgh School of Medicine Assistant Professor of Pediatrics Division of Pediatric Hematology/Oncology and Blood and University of Pittsburgh School of Medicine Marrow Transplantation Pediatric Infectious Disease Children’s Hospital of Pittsburgh of UPMC Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Kathryn Torok, MD Michael C. Ost, MD Assistant Professor Pediatrics Chief Division of Rheumatology Division of Pediatric Urology UPMC & University of Pittsburgh Scleroderma Center Vice-Chairman Children’s Hospital of Pittsburgh of UPMC Department of Urology Pittsburgh, Pennsylvania Children’s Hospital of Pittsburgh of UPMC Associate Professor of Urology Rajiv Varma, MD University of Pittsburgh School of Medicine Clinical Associate Professor Pittsburgh, Pennsylvania Clinical Director Division of Pediatric Neurology Ward Richardson, MD University of Pittsburgh School of Medicine Assistant Professor of Surgery Children’s Hospital of Pittsburgh of UPMC Division of Pediatric and General Thoracic Surgery Pittsburgh, Pennsylvania University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Pushpa Viswanathan, MD Pittsburgh, Pennsylvania Assistant Professor Division of Pediatric Endocrinology Melissa M. Riley, MD University of Pittsburgh School of Medicine Assistant Professor of Pediatrics Children’s Hospital of Pittsburgh of UPMC University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Pittsburgh, Pennsylvania Margalit Rosenkranz, MD Assistant Professor University of Pittsburgh School of Medicine Division of Pediatric Rheumatology Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania x Contributors Daniel J. Weiner, MD Katelyn Woods, DMD Associate Professor of Pediatrics Pediatric Dental Services Department of Pediatrics Children’s Hospital of Pittsburgh of UPMC University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Co-Director Antonio J. and Janet Palumbo Cystic Fibrosis Center Robert F. Yellon, MD Medical Director Professor of Otolaryngology Pulmonary Function Laboratory University of Pittsburgh School of Medicine Children’s Hospital of Pittsburgh of UPMC Co-Director Pittsburgh, Pennsylvania Division of Pediatric Otolaryngology Director John V. Williams, MD ENT Clinical Services Chief Children’s Hospital of Pittsburgh of UPMC Division of Pediatric Infectious Diseases Pittsburgh, Pennsylvania Professor of Pediatrics University of Pittsburgh School of Medicine Fateema Turay Rose, MD Pittsburgh, Pennsylvania Fellow, Pediatric Gastroenterology University of Pittsburgh School of Medicine Member Shelley D. Williams, MD Division of Gastroenterology Associate Professor of Pediatrics and Neurology Children’s Hospital of Pittsburgh of UPMC University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Division of Child Neurology Children’s Hospital of Pittsburgh of UPMC Basil J. Zitelli, MD Pittsburgh, Pennsylvania Professor of Pediatrics University of Pittsburgh School of Medicine Selma Feldman Witchel, MD Director Associate Professor of Pediatrics The Paul C. Gaffney Diagnostic Referral Service Pediatric Endocrinology, Diabetes and Metabolism Children’s Hospital of Pittsburgh of UPMC University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Children’s Hospital of Pittsburgh of UPMC Pittsburgh, Pennsylvania Jennifer E. Wolford, DO, MPH Assistant Professor of Pediatrics University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania To our parents, who were our first teachers: Hannah L. Zitelli and Patsy A. Zitelli Thomas P. Nowalk and Lourdes W. Nowalk George M. McIntire and Charlotte M. McIntire To my wife, Suzanne, and my children, Matthew, Daniel, Benjamin, and Anne Zitelli To my wife, Amy Brinkos, and my children, James, Max, and Peter Nowalk To my brother, John, and my children, Frances and Madeline Marcelle To those exceptional teachers we have had, whose dedication, enthusiasm, and creativity helped make the acquisition, application, and sharing of knowledge more fun than hard work and who inspired us not only to perform to the best of our ability but also to become teachers as well as physicians: Henry Furrie, Paul C. Gaffney, MD, William H. Zinkham, MD, J.R. Zuberbuhler, MD, Crystie Halsted, MD, Ronald Lemire, MD, J. Carlton Gartner Jr., MD, William I. Cohen, MD To our residents and students, whose eagerness to learn and to put their knowledge to use keeps us learning actively and makes teaching so rewarding FOREWORD There aren’t many texts that stand the test of time, but the book you It is often said that the art of the physical exam is atrophying from hold in your hand, or – more likely, given its considerable heft – on disuse, as are medical libraries of physical books, both victims of the your lap or desk, has been proving its worth to students of pediatrics digital age. Yet, the physical exam (along with the medical history) at all stages of their training and careers for 30 years and 7 editions. remains essential to the complete physician, and this book is a price- Zitelli and Davis (now ably edited by Drs Zitelli, McIntire, and less reminder of the value of an actual book, with pages, stunning Nowalk – all widely admired clinicians and diagnosticians) is revered pictures, chapters, and indices. for its breadth and depth, and especially for its extensive use of Enjoy this book, and learn from it, and keep going back to refer superb visual material, including striking photographs, radiographs, to it, as generations of clinicians before you have done with previous and data graphs. editions. David M. Orenstein, MD, MA Antonio J. and Janet Palumbo Professor of Cystic Fibrosis Director Emeritus, Antonio J. and Janet Palumbo Cystic Fibrosis Center Chair, Ethics Committee Children’s Hospital of Pittsburgh of UPMC Professor of Pediatrics School of Medicine Professor of Health and Physical Activity School of Education University of Pittsburgh xii
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