A ten-year-old girl presented to the Pediatric Primary Care clinic with a two-week history of continuous cervical pain, which appeared spontaneously, as well as consolidation in the right cervical region.
Accompanying affection is found, without other symptoms and personal history lack interest.
No history of trauma or infectious processes was reported in the previous weeks.
In the physical examination, only a mass located in the right laterocervical region is detected, with signs of pain close to deep inflammatory denomination, located in the third of the posterior border mobile to the non-demarcated skin, inclavicular prominence.
The child did not report anorexia or weight loss.
due to the clinical presentation, the possibility of a tumor pathology was raised, especially malignant due to the characteristics of the mass; however, we do not rule out the existence of other causes such as contracture or fibrosis of the muscle-M
We decided to initiate antiarrhythmic therapy and review it within a week.
After this time, the pain had partially improved but the cervical mass persisted with similar characteristics, so a study was requested with complete blood count, biochemistry and C-reactive protein (CRP), chest serology, antibiotic treatment with Mantoux test.
Complementary tests: haemoglobin, 14.5 g/dl; hematocrit, 41.2%; leukocytes, 8040/μl (43% neutrophils, 49% lymphocytes); platelets, 356000; biochemistry: ionogram, blood glucose, hepatic function
Mantoux test was negative.
Serology for toxoplasma, cytomegalovirus and Epstein-negative enterovirus.
The imaging tests were conclusive, in view of both the chest X-ray and the left echographic examination of a right costochondrium consisting of a syndrosis between two costal segments that departed from the left vertebra.
In conclusion, the child had a right cervical rib and left rudimentary.
He is currently followed up in Primary Care Pediatrics and has no complications.
