Sonography of pediatric superficial lumps and bumps: illustrative examples from head to toe

Superficial lumps and bumps are extremely common in children, and the vast majority ultimately prove to be benign. Duplex/color Doppler ultrasound (US) has emerged as the first-line imaging modality for the evaluation of these superficial pediatric masses because it provides a means for rapid acquisition of information including size, shape, location, internal content and vascularity. More important, it does so without utilizing radiation, iodinated contrast material or sedation/anesthesia. In this review, we present the sonographic findings of a variety of cases ranging from head to toe that are either uncommonly seen or were diagnosed in an atypical fashion (i.e. ultrasound). In situations where the lesion is too deep, hyperechoic or large to be fully assessed within the field of view or if malignancy is suspected, then additional cross-sectional imaging is warranted for further evaluation.     

Creating meaning and value in substance abuse education 1

Medical faculty committed to teaching about substance abuse face the challenges of teaching about a stigmatized disease. They often work with little support and few colleagues. These clinician educators must find tools to help sustain them in this work. Knowledge of emerging data on effective diagnosis and treatment of substance abuse in the primary care setting and excellent clinical skills in managing patients with substance abuse are key. More important is the ability to find sustenance and inspiration in working with the addicted patients who have been our teachers.