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Delayed puberty is defined as the absence of any signs suggestive of puberty by 14 years of age. In this case, the patient's pubertal delay appears to be constitutional because of his positive family history, absence of syndromic features or systemic illness, and bone age of 12 years. Puberty correlates more closely with bone age than chronological age. On follow-up, the patient will most likely demonstrate a similar onset of puberty as his father.

This particular video is intended as a demonstration of a physical exam that may be useful in evaluating a patient with shoulder pain.

It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It is also intended not as a perfect example of a physical exam that would be performed for a patient in clinical practice, but is designed to optimize function and efficiency for a OSCE testing setting.

Instead, it should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.

Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.

Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video.

Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.

This membrane could prevent heart attacks and keep the heart alive.

The mainstay of treatment is usually medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

Pancreatic cysts are saclike pockets of fluid on or in your pancreas, a large organ behind the stomach that produces hormones and enzymes that help digest food. Most pancreatic cysts aren't cancerous, and many don't cause symptoms. They're typically found during imaging testing for another problem. Some are actually noncancerous (benign) pockets of fluids lined with scar or inflammatory tissue, not the type of cells found in true cysts (pseudocysts). But some pancreatic cysts can be or can become cancerous. Your doctor might take a sample of the pancreatic cyst fluid to determine if cancer cells are present. Or your doctor might recommend monitoring a cyst over time for changes that indicate cancer.

Breath sounds can be either normal or abnormal. These sounds come from the lungs when you breathe in or out. These sounds can be heard using a stethoscope or simply when breathing. Abnormal breath sounds can indicate a lung problem, such as: an obstruction inflammation an infection fluid in the lungs asthma Listening to breath sounds is an important part of diagnosing many different medical conditions.

This video describe the clinical managment of a patient with hyperprolactinemia, including the approach to diagnosis, important endocrine testing, and management options.

Reiter syndrome is a type of reactive arthritis that happens as a reaction to a bacterial infection in the body. The infection usually happens in the intestines, genitals, or urinary tract. Reiter syndrome includes redness, joint swelling and pain, often in knees, ankles, and feet, along with inflammation of the eyes and urinary tract. It is not contagious. But the bacteria that trigger it can be passed from one person to another. There is no cure for Reiter syndrome, but you can control the symptoms. For most people, symptoms go away in 2 to 6 months.

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