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Ask Dr Uzair Your Own Question

Dr Uzair
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6957
Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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, I have a 7 month old baby boy. He has been growing

Resolved Question:

Hello,
I have a 7 month old baby boy. He has been growing well and we have taken him for regular checks etc. About 6 days a ago we noticed while changing him we noticed on his right leg where the top of his leg meets the torso the crease is a little swollen or bigger than the left leg, he has a crease on both sides it's just that one is a little more swollen. It is not red or tender nor is he crying or showing any symptoms of pain. I thought of hip dysplasia but then I read this is more common in babies born in breach, girls and those with a family history of hip problems, none of these apply in this case. Also I put him on s flat table and bent his knees and put his legs close together and they are both level which I read can be used as a test to see If the hips are uneven. He was also checked at his 6 weeks and was fine. Could you please advise on what you think this could be?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Uzair replied 2 years ago.
Dr Uzair :

Hi. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.

Dr Uzair :

Is the swelling there all the time? Or does it appear at certain times of the day.

Dr Uzair :

Please enter chat and use reply to respond.

Customer: Hello
Dr Uzair :

Hi.

Customer: There are times when it seems more swollen and other times it does not
Dr Uzair :

Alright, does it appear to bulge out when he is crying? or straining?

Customer: no
Customer: I also thought of inguinal hernia
Customer: But the bulge is not located where the hernia is
Customer: Let me try to explain where it is
Customer: Just where top of the leg meets the body in the corner there it's like a roll or crease he has them on both sides but the one on the right side is more swollen
Customer: Or bigger
Customer: It's not red or inflamed or anything like that
Dr Uzair :

It would be helpful if you can send in a picture.

Customer: I am not able to as I am writing from my tablet
Customer: It's right on the corner where the leg meets the body on the inner part of the thigh
Dr Uzair :

Alright, inguinal hernia is one possibility but there are others as well like a femoral hernia, which is also common in children of his age group.

Customer: But the location does not indicate hernia
Dr Uzair :

Another possibility is of a saphenavarix.

Dr Uzair :

Hernias are of all types. There are inguinal hernias - direct or indirect. Then there are femoral hernias, which appear almost at the inguinal crease towards the pubic bone.

Dr Uzair :

Can you tell me if his scrotum seems developed and if you can feel his testis in the scrotum?

Customer: But this is not near the pubic bone
Customer: This is like a roll which goes round
Customer: You can also see it when you look from behind
Dr Uzair :

Okay, then I guess I am having a problem understanding where this is. Let me send you a picture of an anatomy slide and using your tablet you can mark the area where this is located.

Customer: Okay
Customer: I am not sure how I would do that
Dr Uzair :

Full Size Image

Dr Uzair :

Can you work on it?

Customer: Okay you see where the groin Is imagine there is like a crease there which goes all the way round
Dr Uzair :

Okay so much lower than where the inguinal hernia would be?

Customer: So like a skin fold cause all the way round you can also see it from being as well if you are looking at buttock
Dr Uzair :

Okay! I think I understand where it is. And is this symmetrical on both sides?

Customer: It's not near where the hernia is but rather where the groin is its just a bigger crease or fold of skin which can be seen at the front and also when looking from the back
Customer: It is
Customer: Symmetrical but one side is more swollen or one of the creases is bigger
Dr Uzair :

Full Size Image

Dr Uzair :

Can you do this easily or is there resistance?

Customer: Yes we can do this essily
Customer: Okay you see in the diagram the crease is where the thumb is and goes all the way round so you can see it from the behind
Customer: They are the same on both side only one side the right seems more klk
Customer: more swollen
Dr Uzair :

Full Size Image

Dr Uzair :

Can you straighten his legs without causing additional creases on the thighs?

Customer: I also bent his knees and put the legs close to together and the knees re
Customer: yes we are able to straighten without causing additional creases
Dr Uzair :

Okay, then this is a soft tissue swelling.

Customer: You see the last foto you sent there the green lines correspond only one side the crease is more swollen
Customer: What do you think?
Dr Uzair :

Is it soft, firm or hard?

Customer: soft
Customer: for sure very suft
Customer: Soft*
Customer: How can we tell if it is dysplasia
Customer: and if it is soft tissue swelling what would cause it in this location?
Dr Uzair :

This does not sound like dysplasia.

Dr Uzair :

Can you feel any borders of the swelling or does it appear to merge with the rest of the body.

Customer: I am not sure I understand what you mean
Customer: it seems to all merge with the body but just that this part looks more swollen or puffy
Dr Uzair :

I mean, does the swelling circumscribed - has borders which you can feel or is it diffuse? Am I making it harder? I am trying to figure out a way to get around the medical jargon, (there is no shortcut to a physical examination or seeing a picture)

Dr Uzair :

*feel circumscribed with well defined borders?

Customer: I think puffy Is probably a better word because it's not red or inflamed nor is he in any pain it's just puffy that last foto you sent with the green lines from the buttock they the
Customer: that's the best way to show where it is so you see where the green lines are in this cas
Dr Uzair :

Yes.

Customer: this case they are symmetrical but just imagine below the green line there on one side one of the creases is more puffy
Customer: It's not misaligned because he has the same on the other leg but one is more puffy
Customer: Or swollen whatever word is right to use in this csse
Dr Uzair :

Have you had him vaccinated recently, a few weeks back?

Customer: I understand it's though
Customer: no we had vaccinations done the last one was at three months
Customer: But what does this sound like? I understand it's tought to say but what are your thoughts
Dr Uzair :

Okay, this is the area where there are inguinal or groin lymph nodes.

Dr Uzair :

So, it could well be lymphadenitis.

Dr Uzair :

The best way to reach a narrow differential will be an ultrasound.

Customer: Yes we will take time to
Dr Uzair :

It will rule out any swelling, soft tissue, hernia, lymph nodes.

Customer: him to get checked
Dr Uzair :

That is the best course of action at this point in time i.e., if you can not get in to see his paediatrician.

Customer: But at the moment my concern is hip dysplsia?
Customer: Does this seem like it
Dr Uzair :

I don't want to shoot arrows in the air and cause any anxiety since, I have not seen the swelling.

Dr Uzair :

But it does not seem like hip dysplasia at all.

Customer: but what does swelling from lymph nodes seem like
Customer: brcau
Dr Uzair :

First of all, hip dysplasia would not present out of nowhere after 6 months. Secondly, with dysplasia the legs are of unequal lengths, there are asymmetrical creases on both sides and most of the times the crease in lower don on the thigh when you put the legs together, the knees don't match in length.

Dr Uzair :

In children, the most common cause for lymphadenitis (swollen lymph nodes) is idiopathic - which literally means that they swell up without a cause.

Dr Uzair :

Then another common cause is vaccines like Typhoid or the MMR.

Customer: and how do these get resolved
Customer: yes he has not yet had those iMMR is coming up soon I think
Dr Uzair :

Infections are also a cause but they present with fever as well, since there's no fever, infections are out of the list.

Customer: Okay I have a question in this case
Dr Uzair :

Lymph nodes without a cause, resolve on their own in a few months. Those with a cause need an evaluation and then the cause is treated and the lymph nodes get back to their size.

Dr Uzair :

Sure, go ahead please.

Customer: Do you understand where I am describing this to be? I know it's difficult without s foto but do you follow from my description where I am mentioning the swelling?
Dr Uzair :

Yes, it is under the inguinal crease and goes all the way around to the side of the upper thigh.

Customer: No it's on the inside of the upper thing and goes all the way round from front to back
Customer: So if you are looking from the front you can see it and also if you look from the back it's just sort of under the bottom
Customer: As I say he has the same crease and shape on the left side just that the tissue on the right in that area appears more puffy and it seems some does its puffer and other days less so we only noticed this about 6 days ago
Dr Uzair :

Okay.

Customer: I am thinking how can I send a foto but I don't think I can through the ipad
Dr Uzair :

So, we have a few differentials here, in order of priority - swollen lymph nodes, lipoma, inguinal hernia, sphenavarix.

Dr Uzair :

Well, you can actually. Take a photo and attach it to a photosite like photobucket.com or send me a link to your dropbox (if you use the app).

Customer: fotobucket is a public site so not sure I am comfortable with that
Dr Uzair :

Yeah, but no one can trace an anonymous post back to you. You don't have to include your baby's face in the picture.

Customer: What's another way?
Customer: Or is there another eay
Customer: Way
Dr Uzair :

There is, you can send the picture to customer services telling them that you need to get it to me (Dr Uzair) and they will email the pictures to me, but that may take a few hours.

Customer: Any other alternative?
Dr Uzair :

The last way is, that I can send you my email address, but the only way of doing that is that I send you my additional services request, if you accept it, then the site will allow me to post my email address to you.

Customer: or those are the only ways round it
Customer: additional services request what does that mean..
Dr Uzair :

Other wise, the site will block my email address and possibly my account for violating its policies.

Dr Uzair :

It's requires an additional payment on your part. I can minimize the payment but if you accept it, the chat interface will convert in to a Q and A thread and you will be automatically paying me for the original question.

Customer: do you know what the additional cost would be?
Dr Uzair :

And since, we've gone this far, I can put the additional payment in cents for you.

Customer: i am not sure I follow the part about auto can
Customer: automatically converting into a thresd
Customer: Okay so what do I need to do in this case?
Dr Uzair :

You've offered to make a payment of US $ 16.78 for this question, if you accept the additional services offer, you will be accepting that you make that payment to me.

Dr Uzair :

Nothing, you just need to say the word and I'll send the request which will appear on your screen.

Customer: I am a little confused cause I was billed £24 for this question
Dr Uzair :

Yes, part of that payment goes to me.

Customer: so am I now going to billed extra on top of that
Dr Uzair :

0.99 cents for the additional services, that is the only way I can send you my email address. But if you don't want that, then you can use any of the other methods we talked about.

Dr Uzair :

I usually tell my patients and customers to post their pictures on photobucket if they can not attach them to this applet or thread.

Dr Uzair :

That is the most convenient way.

Customer: Hmm it sounds a little complicated
Customer: I am not to sure about fotobucket To be honest nothing personal or anything it's just one of those things
Dr Uzair :

Haha, okay. So, we can continue without the picture, I'm trying to make it easier for both of us, but it ended up getting more complicated.

Customer: p
Customer: yes yes I appreciate your help
Dr Uzair :

We can start discussing the differentials.

Customer: my concern is hip dysplasia
Customer: that was the reason why I wanted a medical opinion
Customer: I am just trying to think if there is a way I can get a diagram of the Internet to show you the exact location
Dr Uzair :

Okay let me ask you some questions to rule out congenital or developmental hip dysplasia.

Dr Uzair :

Do you hear a click or clunk when you squat or straighten his hips?

Customer: No
Customer: https://instruct.uwo.ca/kinesiology/222/Lab6/lab6.html
Customer: Please go this link and then on the diagram of the person do you see where it shows ischial tuberosity
Customer: so no just under the so just beneath the buttock imagine a puffy tissue or a swelling compared to the other side
Customer: So just under the gluteal fold there is a puffy tissue or swelling it's not round like s ball or anything
Customer: it's not like a swollen ball or anything like that it's just like an extra fold under the gluteal fold it's more puffy that the right side
Dr Uzair :

Towards the inside?

Customer: it goes round so you can see it just under the fold from the back and then from the front as well so it's like a line going from front to back vertically
Dr Uzair :

Vertically or diagonally?

Customer: As in diagonally
Customer: so say you are looking from the front you will see a fold on the upper inner thigh and when you look from behind you will see the fold also underneath the gluteal looking slightly puffy
Customer: does that make sense
Dr Uzair :

Okay, let me simplify this (if I dare).
If you notice no asymmetry in the gluteal folds, if there are no clicks or clunks on adducting and abducting his thighs, if there is no limb length inequality and if the paediatrician has examined him and did not mention congenital hip dysplasia (CHD), then this is definitely not CHD.

Dr Uzair :

And, the head of the femur, dislocates to the outside, not the inside, so there is no fold on the upper inner thigh in a CHD patient.

Customer: http://hipdysplasia.org/developmental-dysplasia-of-the-hip/infant-signs-and-symptoms/asymmetry/
Customer: Look atht
Customer: the first diagram it shows that they are not equal
Customer: now in his case they are equal
Dr Uzair :

Yes, it does, this is the gluteal crease, the baby is shown from behind, you said that the gluteal creases are equal in your boy's case.

Dr Uzair :

Exactly, so they wouldn't be equal if he had hip dysplasia.

Customer: they are but
Customer: one is more swollen
Dr Uzair :

So, that confirms that he does not have hip dysplasia.

Customer: So how you see the diagram shows the
Customer: The crease sticking out more so his does as well but they are equal but it sticks out cause of the
Dr Uzair :

There are a lot of reasons for a swelling, as I made mention of a few in the start and one can not comment on what kind of swelling it might be without a physical examination.

Customer: swelling
Customer: would a picture help
Dr Uzair :

Unlikely, that what your boy has is a major hip dysplasia.

Dr Uzair :

The legs are equal in length, there are no clicks and clunks, he has had a physical examination by a paediatrician.

Dr Uzair :

I doubt that the case here is a hip dysplasia.

Customer: yes would a picture help.
Customer: From the back or the front.
Dr Uzair :

If you are going to send a picture, send both, from the back and the front with the legs straight and the knees placed together.

Customer: Okay
Customer: I have taken fotos
Dr Uzair :

Okay.

Customer: are you still here
Dr Uzair :

Yes, I'm here.

Customer: let us do it the most secure way
Customer: I am sure you understand
Dr Uzair :

Okay. Which one is you think is the most secure way?

Customer: Your email
Customer: preferably please
Customer: but can we still continue in the chat?
Dr Uzair :

Alright, I am going to send you the additional services request. Accept it, the chat will be converted to a q and a thread, we'l go back and forth on that.

Customer: its easier to type and to respond/discuss
Dr Uzair :

The chat automatically converts.

Customer: Okay
Customer: let's do it so I can get your view please
Dr Uzair :

Did you get the "offer"?

Customer: No
Dr Uzair :

Okay, I sent it.

Customer: Didn't get anything
Customer: do I get it in this chat
Dr Uzair :

Check your email as well.

Customer: i don't have an emIl
Customer: tied to this chat
Dr Uzair :

Okay.

Dr Uzair :

That is why the offer didn't go through.

Customer: i mean to this request
Customer: leta just send it to the other place
Customer: let me send it there what's it called
Dr Uzair :

Sure, send it to customer services.

Customer: customer services will take hours you said
Dr Uzair :

Yes, usually does.

Dr Uzair :

Drop box?

Customer: yes
Customer: lets just do it that way
Customer: also can I have the pictures removed from there
Customer: on
Dr Uzair :

Okay, save the picture in your dropbox and send me the link here.

Customer: after you have taken a look
Customer: i don't have a dropbox
Dr Uzair :

Yes, just simply take the picture out of the dropbox and it'll be gone

Customer: Is it an app?
Dr Uzair :

Yes, you can find it on the apple store and download it.

Dr Uzair :

Takes a couple of minutes.

Customer: onr sec please
Dr Uzair :

Sure.

Customer: Okay I have downloaded Dropbox
Customer: now what
Dr Uzair :

Sign in and simply save your picture in it.

Dr Uzair :

then open the picture, click on the options/sharing icon and select copy link.

Dr Uzair :

Then paste the link in this text box.

Customer: It's bit tricky it's importing all my fotos
Dr Uzair :

you can cancel that now or later, no one can see those pictures except you.

Dr Uzair :

Just let it copy and then open the picture you want me to see and generate the link and paste it here.

Customer: Okay I have an issue I deleted those fotos by mistake
Customer: I need to see how to get them back
Customer: its not letting Leger them back
Dr Uzair :

Okay.

Dr Uzair :

Just copy the pictures from your photo gallery and paste them in the drop box.

Dr Uzair :

Then generate the link and paste here.

Customer: It won't let me paste them I think I have the wrong version of drop box I think I need it for ipad
Dr Uzair :

No. The free works fine.

Dr Uzair :

In your photo gallery, open the options for that picture and it will say share with or send to drop box

Customer: Okay but it's not letting me do anything with the fotos
Customer: i don't have anything in my foto gallery
Customer: thats the problem
Dr Uzair :

Where did the photos you took go?

Customer: I deleted them from drop box
Customer: they got imported and then I deleted them by mistake
Customer: so I don't know how to get them back
Customer: in drop box
Customer: they are still on my iPad
Dr Uzair :

Okay, open your drop box. There are three dots on the right upper corner.

Customer: But not in the Dropbox
Dr Uzair :

Tap on that, it will open a pop up.

Dr Uzair :

Click on photos

Dr Uzair :

That will take you to your gallery.

Customer: Yes but they are not in there
Dr Uzair :

And then you can select the photos you want to import to the drop box.

Customer: I deleted them from drop box
Dr Uzair :

I am telling you how to get them there.

Dr Uzair :

There are three dots on the upper right corner when you open the dropbox app.

Customer: I only have two options
Customer: when I click on the three dots
Customer: rename and move
Dr Uzair :

"Add files?" option there.

Customer: No
Dr Uzair :

Any where on the screen?

Dr Uzair :

On the screen of your Ipad, does it say "files" anywhere?

Customer: No
Dr Uzair :

Do you have your drop box open?

Dr Uzair :

See if you can find an icon on the lower left corner that says files.

Customer: Yes
Customer: there is
Customer: it says to create an account to link to my computer
Dr Uzair :

Tap on that.

Customer: do I need to do that
Dr Uzair :

No. Skip that.

Dr Uzair :

Once, your on the files screen, tap the three dots icon.

Customer: Says set up now when I click on files
Dr Uzair :

Then add files.

Customer: Still gives me only rename and move
Dr Uzair :

Okay.

Customer: it won't let me do anything when I click on files besides set up now
Dr Uzair :

Then try to set up like it wants you to.

Customer: Okay
Customer: found add files
Customer: adding those now
Customer: what next once they are in
Dr Uzair :

Great!

Customer: It's. Still adding all the other stuff
Customer: i don't know how to stop it
Dr Uzair :

Once, they are in, open the file/photo you want to show me.

Customer: how do I stop it downloading all my fotos there are like 300!!
Customer: Okay I opened it now what
Customer: there are 3 fotos to show u
Dr Uzair :

There is an icon - an arrow coming out of a box, right next to the three dots when you open the picture. On the upper right corner.

Dr Uzair :

Do you see it?

Customer: Yes
Customer: i see it
Customer: Click on that on copy link?
Dr Uzair :

Okay, tap on that and then you will see a tab that says generate link

Dr Uzair :

Or copy link, yes.

Customer: No only copy link
Customer: and some other options
Dr Uzair :

Yes, tap on that.

Customer: nothing to generate
Dr Uzair :

And it will generate a link

Customer: Okay now?
Dr Uzair :

Paste it here.

Customer: No option to paste
Dr Uzair :

Tap and hold on this text box for 3 secs and the option box should open.

Customer: When I tap in the box here to paste it doesn't give me s paste option
Dr Uzair :

Try the copy link again.

Customer: When I hold in this box it just creates a bubble
Customer: doesnt give me an option to paste
Dr Uzair :

Okay tap and hold and then let go to get the options.

Customer: I don't get any options
Customer: when I tapin this box
Dr Uzair :

Okay.

Dr Uzair :

Did you try again - copy link and paste again.

Customer: have twide
Customer: twice
Dr Uzair :

Okay. I don't why that is happening. It should normally just give an option to paste after you have generated a link.

Customer: Hmm
Customer: It says link generated
Dr Uzair :

Yes! And then you should be able to paste it here.

Customer: It doesn't give me this option
Customer: i don't know what else to do
Customer: i am taping in the box here but it does not allow me to paste or give me an option to paste
Dr Uzair :

Photobucket.com - create a log in there and send me the link of the picture. You can delete it thereafter if you are concerned about privacy issues.

Customer: If
Customer: I copy and past the foto in here will it work that way?
Dr Uzair :

You can try it, but I doubt it.

Customer: No doesn't wor
Dr Uzair :

I've never tried that.

Customer: just tried it
Dr Uzair :

Alright.

Dr Uzair :

Then, photobucket?

Customer: What can I do
Customer: it's getting s little frustrating
Customer: is there another option
Dr Uzair :

You tell me! :)

Customer: its cause am on an ipad
Dr Uzair :

No, not really, we've exhausted all the options except the photobucket one.

Customer: okay so what do I do with that
Customer: how does that work
Dr Uzair :

Yes, probably is. Mac / iOS is not compatible with a lot things.

Customer: I need to create an account on line there
Customer: okay but foto bucket should work
Customer: right
Customer: so what do I need to
Customer: do now
Dr Uzair :

You go to the website. http://www.photobucket.com/

Dr Uzair :

It says "upload" on the top left.

Dr Uzair :

Click there. Sign in with your Facebook.

Customer: I can't paste the fotos on Facebook?
Dr Uzair :

No, it is just going to use your facebook id to sign in to the website.

Dr Uzair :

So, that you don't have to fill up their sign in form.

Customer: Yes but then says it will post all my stuff to fotobucket
Customer: let me just fill their form
Dr Uzair :

Okay.

Customer: bare with me 2mins
Dr Uzair :

Sure, no problem. :)

Dr Uzair :

Let me know when you're done.

Customer: Okay now what
Customer: I am in I think
Dr Uzair :

Copy the link to that page where your photo shows and paste it here.

Dr Uzair :

It should say link to share photos on the top right corner.

Customer: Do I need to import th e fotos first
Customer: into the fotobucket
Dr Uzair :

Yes! I thought you had done that.

Customer: How do I delete them from fotobucket after I have brought them in
Customer: am I the only one who can see them
Dr Uzair :

It will give you options, the delete option should be on the lower right corner.

Dr Uzair :

http://support.photobucket.com/hc/en-us/articles/200724324-Linking-and-Embedding-Images

Dr Uzair :

follow this link to get an idea.

Customer: http://s725.photobucket.com/user/Johnsmith261/media/image.jpg1_zpsb9tfh6te.jpg.html
Customer: http://s725.photobucket.com/user/Johnsmith261/media/image.jpg3_zpsvale3i8v.jpg.html
Customer: http://s725.photobucket.com/user/Johnsmith261/media/image.jpg2_zpskudhu9gs.jpg.html
Customer: Did they work?
Dr Uzair :

Yeah!

Customer: Hello
Customer: okay
Customer: can you see what I am describing
Customer: what does this look like
Dr Uzair :

Congratulations. This is not a hip dislocation.

Customer: what is this.
Dr Uzair :

Looks like a pad of fat at the minimum or a femoral hernia.

Customer: and how can you tell have yous
Customer: what is the most likley can you see
Dr Uzair :

Could be any of the later two. An ultrasound will differentiate.

Customer: what makes you think fermor so hernia can you see the front and the back
Customer: but would hernia show so much at the back
Customer: Also what about lymph nodes
Dr Uzair :

Yes, I can. It is a differential that comes to mind whenever there is a swelling under the inguinal crease on the medial side, similar to this one. No, it wouldn't show like that all the way up to the back, but there is nothing restricting it from going there either.

Customer: and the other things you suggested this just appeared in the last week
Dr Uzair :

Lymph nodes do not extend all the way up to the inner thigh like this.

Customer: does this look like swelling
Dr Uzair :

Yes, definitely a swelling (hernia is also a swelling).

Customer: what other symptoms would he have if it were hernia
Dr Uzair :

It would expand with straining and when he is crying.

Customer: but from the front does it look like herinia
Customer: no it doesn't seem to do that
Customer: what else could this be?
Dr Uzair :

Okay, then really, you need to have this evaluated with an ultrasound. That is the first thing you're paediatrician is going to order.

Customer: Also if it is hernia how is it trea
Dr Uzair :

If its a hernia a surgery will be required.

Customer: okay does it look serious
Customer: i mean from what you see here
Dr Uzair :

Not from the looks of it. Serious conditions are not so shy in their presentation. Bogy, red, swollen and painful.

Customer: what do you think it looks like
Customer: from experience
Dr Uzair :

I told you, either this is a pad of fat (lipoma) or a femoral hernia.

Customer: not to make assumptions but generally
Customer: what causes lipoma?
Customer: Can they just appear
Dr Uzair :

There is no cause, they just appear - the cause as they say is Idiopathic! Sometimes, they are genetic (Durcum's disease), but then they should be symmetrically on both sides and more than one. And the parents usually have them as well.

Dr Uzair :

They just appear.

Dr Uzair :

So, it can be a lipoma that just appeared without a cause.

Customer: okay it doesn't swell up when he cries
Dr Uzair :

Okay. Then more inclination towards this being a Lipoma.

Customer: he is crying now and it's not coming up more
Dr Uzair :

Okay.

Dr Uzair :

Still one should keep it in the differentials list because one can not solely rely on the cough impulse or straining in femoral hernias.

Customer: okay
Customer: but does this look like hip
Customer: what makes you sure it's not hip related
Dr Uzair :

No, it doesn't. You see, the legs are both equal, they are not tilted and this appears as a separate swelling then the gluteal crease, the real gluteal crease is present at its normal location in your boy, plus congenital hip dysplasias are present from birth and your paediatrician would have picked it up during the physical examinations. And there are no clicks and clunks there either.

Dr Uzair :

If you're going to twist my arm hard enough, you might make me say this is a congenital hip dislocation, but its not.

Customer: Okay
Customer: i am not trying make you say it is I just wanted a view
Customer: in your professional opinion looking at these fotos
Dr Uzair :

Okay. Do you think you have my opinion?

Customer: whats the most likely thing you suspect
Dr Uzair :

Lipoma vs Femoral hernia.

Customer: okay
Customer: with hernia
Customer: surgery is it complicated
Customer: how is recovery etc
Dr Uzair :

Not complicated at all.

Dr Uzair :

Recovery - as in when the stitches will be removed - in about 7 to 10 days.

Customer: Okay
Customer: so should we be concerned
Customer: having had a look at the fotos
Customer: we are taking him to be seen
Customer: but it's not a hip displacement
Dr Uzair :

No, I don't think you need to draw any conclusions before the paediatrician has seen him.

Customer: no I mean
Customer: should we be concerned
Customer: about if it's something serious
Dr Uzair :

I can only draw an inference from what I can see and what you have told me. This does not look to be anything serious.

Customer: He has Ben fine
Dr Uzair :

By serious I mean, something that would have a long lasting effect or something that can not be treated.

Customer: he has not shown any signs of pain no crying no fever or anything at all
Dr Uzair :

Okay.

Customer: as I said we just noticed this few days ago
Customer: you said lipoma should be on two sides
Customer: but can it be on one side?
Dr Uzair :

No! that is not what I said.

Dr Uzair :

I said, a lipoma without a cause can be on any side - solitary

Dr Uzair :

But those associated with a disease like Durcum's disease are on both sides. This is not durcum's disease.

Dr Uzair :

It can be a lipoma on one side that just appeared without a cause.

Dr Uzair :

I think we are taking too much time and going around in circles.

Customer: Ok
Dr Uzair :

Lets just leave it at this: This does not look like a hip dislocation, it looks like a lipoma or a femoral hernia at the most.

Customer: okay
Dr Uzair :

Take him to see the Paediatrician and have an ultrasound done after the examination.

Customer: thanks for for your patience
Dr Uzair :

It was a pleasure.

Customer: sorry
Customer: one more thing
Dr Uzair :

Let me know if you have any future concerns and what your paediatrician says this is after the evaluation.

Dr Uzair :

Sure.

Customer: what would be the main thing with the hip
Customer: i mean how would we know
Customer: Last question
Customer: and also what would cause a fermoral hernia
Dr Uzair :

Your paediatrician will find out on the physical examination if this is a hip dislocation, if s/he is still unsure, an x ray will confirm.

Customer: but you said it doesn't look like that
Dr Uzair :

Causes of femoral hernias need another hour or two to explain! Starting from the anatomy.

Customer: okay
Customer: don't worry about that
Customer: I will read it online
Customer: you said that this isn't a hip Issue
Dr Uzair :

I did. But you seem to think it is.

Customer: no. No
Customer: i don't I just don't know
Dr Uzair :

You asked:



i mean how would we know




7:05 PM


Last question




7:05 PM


and also what would cause a fermoral hernia

Customer: okay
Customer: yes I know that
Dr Uzair :

I was answering that question: you will know when you're paediatrician will evaluate and confirm with an x ray.

Customer: okay thanks for your time
Customer: but you said
Customer: the fotos don't show problems with the hip
Dr Uzair :

I said it. But you don't believe me.

Customer: so we can assume it's not hip related
Customer: i do
Dr Uzair :

Okay. Thank you!

Customer: I was concerned about the hip
Customer: I believe u
Customer: I am just concerned
Dr Uzair :

It doesn't look like a hip related issue.

Customer: hence why I am repeating a little
Customer: okay
Customer: lers leave it there then
Dr Uzair :

I understand.

Dr Uzair :

Okay. But as a little favor, please do tell me what the Paediatrician labels this as.

Customer: ok
Dr Uzair :

I shall be available on the website, you can reply on this thread.

Dr Uzair :

All the best and take care. And please do not be concerned about this.

Customer: it doesn't look serious?
Customer: Cause we are concerned
Dr Uzair :

For the last time? No, it doesn't. :)

Customer: okay
Dr Uzair :

Do leave a positive rating to compensate for my time and service. I shall be grateful.

Customer: Yes
Customer: thanks again
Dr Uzair :

You're most welcome.

Customer: can you say
Dr Uzair :

Don't forget to follow up. Now I am as concerned as you are!

Customer: 100% it's not hip
Customer: or 95
Dr Uzair :

I do apologize, its only facts and science here. From the information and the pictures, it does not seem to be a hip problem - 95 percent - no hip.

Customer: okay
Customer: thanks
Dr Uzair :

Thank you.

Dr Uzair :

Please leave a positive rating, I shall appreciate it.

Customer: Lipomas
Customer: is there treatment
Dr Uzair :

Yes.

Customer: and how long
Customer: sorry I forgot
Dr Uzair :

They can be taken out.

Customer: to ask
Customer: or do they go away on their own?
Dr Uzair :

You said last question.

Customer: Sorty
Customer: o
Dr Uzair :

No, they have to be taken out unfortunately.

Customer: i forgot to ask
Customer: surgery
Customer: ?
Dr Uzair :

Surgery or liposuction.

Customer: Can they also be left alone
Dr Uzair :

Yes. They can.

Customer: or do they get bigger
Customer: as the baby gets older
Dr Uzair :

Might get bigger but not harmful.

Customer: okay
Dr Uzair :

Sometimes, they stay the same size as the baby grows.

Dr Uzair :

Unpredictable like that.

Customer: why does it appear
Customer: sorry
Dr Uzair :

No reason, as I said.

Customer: I forgot to ask u this
Dr Uzair :

They are just clumps of fat.

Dr Uzair :

All questions answered?

Customer: okay
Customer: and they can just appear
Dr Uzair :

Because now I have to go to work as well.

Dr Uzair :

Yes. They just appear.

Customer: Okay thanks
Dr Uzair :

Pleasure.

Dr Uzair :

Please leave a rating for me.

Customer: common in babies?
Customer: Sorry final final
Customer: is lipoma seen in babies often
Dr Uzair :

Yes, they are common in all age groups. No age restriction with lipomas.

Dr Uzair :

They can appear at any age.

Customer: OKay and suddenly
Customer: okay okay
Dr Uzair :

Its how and when you notice them.

Customer: suddeknly appear
Customer: Ok
Customer: thanks
Customer: for your patience he
Customer: and help
Customer: not a hip issue
Customer: but lipoma or hernia
Customer: can it also just be nothing
Customer: and just be how he is
Dr Uzair :

Yes, that is a possibility.

Customer: but I guess the fact it appeared would indicate it's somethinf
Dr Uzair :

But wouldn't want to say that over the internet without having examined him.

Customer: okay but 95 not hip
Dr Uzair :

Yes.

Customer: so we should not be worried about it being hip
Customer: from the fotos u saw
Dr Uzair :

No!

Customer: no we should not be worried?
Dr Uzair :

No, you should not be worried.

Customer: abiout s hip displacement
Customer: okay thanks doc
Dr Uzair :

Exactly.

Dr Uzair :

Thank you!

Customer: appreciate all the time patience and help
Dr Uzair :

Please do leave a positive rating.

Dr Uzair :

It was a pleasure.

Customer: yes
Customer: thanks
Dr Uzair, Doctor
Category: Medical
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Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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