A 12-year-old girl with sudden onset of numbness and tingling feet. Osseous Ewing's sarcoma of T2.

A 12-year-old, previously healthy girl presented to the Pediatric Emergency Department with back pain and decreased sensation and tingling in her bilateral lower extremities. She had back pain for the past 2 months; the initial episode lasted 2 to 3 days. At that point, she had missed 1 day of school. The pain disappeared, and she returned to her normal activities, including playing soccer and basketball. In fact, she stated, because she was an avid soccer player, that she thought she might have hurt herself. The night before being seen, she noticed back pain between her shoulder blades, together with the decreased sensation, which started in her feet. She was seen in a pediatric urgent care center, where she was examined and discharged with the advice to “go to the Emergency Department,” should her symptoms worsen. By the time she presented to the Emergency Department via Emergency Medical Services on the evening of the next day, her pain had intensifi ed since the morning of admission, and the numbness in her legs had now ascended to the level of her umbilicus. She denied headache, fever, chills, night sweats, and change in her weight. There was no shortness of breath, no cough, no chest or abdominal pain, no urinary or bowel incontinence, no loss of coordination or strength, and no change in her gait. Upon arrival, she was pleasant and in no acute distress. Her vital signs were stable. Her entire exam was norJulia Whitefield MD, PhD, FAAP, is Assistant Professor Pediatric Emergency Medicine, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of New Mexico, Albuquerque. Address correspondence to: Julia Whitefi led, MD, PhD, FAAP, Pediatric Emergency Medicine, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of New Mexico, MSC10 55601, University of New Mexico, Albuquerque, NM 871310001; e-mail: juliawhitefi [email protected]. Dr. Whitefi eld has disclosed no relevant fi nancial relationships. doi: 10.3928/00904481-20100422-06