The Girl with Chest Pain and Bone and Liver Lesions

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, +2 more

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, Ann M. Murray, MD, MPH and Sarah E. Turbett, MD

New England Journal of Medicine

Sep 18, 2025

2 min read

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, +2 more

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, Ann M. Murray, MD, MPH and Sarah E. Turbett, MD

New England Journal of Medicine

September 18, 2025

2 min read

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, +2 more

Lindsay Pindyck Carter, MD, Sjirk J. Westra, MD, Ann M. Murray, MD, MPH and Sarah E. Turbett, MD

New England Journal of Medicine

September 18, 2025

2 min read

In this Case Record of the Massachusetts General Hospital, adapted from the New England Journal of Medicine, an 11-year-old girl with eczema was evaluated for chest and arm pain. Imaging showed multiple bone and liver lesions.

Case Presentation

Patient: 11-year-old girl with eczema and recurrent methicillin-resistant Staphylococcus aureus(MRSA) skin infections.
Symptoms: 7 days of right arm and sternal pain, with nausea/vomiting. No fever or weight loss. No history of trauma.
Social history: New kitten; no recent travel or food exposures.
Physical exam: Right arm and shoulder were tender on palpation. No rashes or skin trauma.
Laboratory data: Elevated inflammatory markers, microcytic anemia. Normal transaminases and renal function.
Imaging: MRI showed T2-enhancing lesions in the right humeral head and sternum, epitrochlear lymphadenopathy, and multiple hepatosplenic lesions (see ).

Clinical Reasoning

Multifocal osseous and hepatic lesions in a child may represen…

READ FULL ARTICLE

Authors

Lindsay Pindyck Carter, MD

Sjirk J. Westra, MD

Ann M. Murray, MD, MPH

Sarah E. Turbett, MD

The Girl with Chest Pain and Bone and Liver Lesions

Topics

Case Presentation

Clinical Reasoning

Authors