An 18-month-old girl presents with asymmetrical breast enlargement. There was no pubic hair growth or body odor and her height was in mid parental range. Her bone age was mildly ad... An 18-month-old girl presents with asymmetrical breast enlargement. There was no pubic hair growth or body odor and her height was in mid parental range. Her bone age was mildly advanced. Which of the following is the best next step in management?
Understand the Problem
The question describes a clinical scenario of an 18-month-old girl presenting with asymmetrical breast enlargement and asks us to determine the best next step in management. We need to consider the possible causes of precocious puberty and which investigation would be most appropriate given the limited clinical findings.
Answer
Consult a pediatric endocrinologist.
Given the asymmetrical breast enlargement, mild bone age advancement, and absence of other signs of puberty, the best next step is to get a consultation with a pediatric endocrinologist.
Answer for screen readers
Given the asymmetrical breast enlargement, mild bone age advancement, and absence of other signs of puberty, the best next step is to get a consultation with a pediatric endocrinologist.
More Information
Asymmetrical breast enlargement in a young girl could be a sign of early puberty or other hormonal issues, but it could also be a benign, non-progressive condition. Given the patient's age and the limited clinical findings, a specialist can best evaluate and guide further management.
Tips
It is important to consider the possibility of precocious puberty, but also to rule out other potential causes of breast enlargement. Remember to assess for other signs of puberty, such as pubic hair, body odor, and rapid growth.
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