Version May 2024
| Condition | Clinical features |
| General | |
| Drug ingestion or overdosage (eg, pseudoephedrine) | History of medication administration |
| Hunger/inadequate feeding | Signs of hypovolemia or undernutrition (eg, sunken fontanelle, dry mucous membranes, decreased subcutaneous fat, etc) |
| Neonatal abstinence syndrome | Maternal history of prenatal substance use or positive urine screen (maternal or infant) |
| Skin | |
| Hair tourniquet of digit or penis | Apparent on physical examination |
| Open diaper pin poking the skin, diaper rash | Apparent on physical examination |
| Trauma (abusive or nonabusive) | Bruising, laceration |
| Eyes | |
| Corneal abrasion or foreign body | May have photophobia, positive fluorescein examination |
| Glaucoma | Chronic or intermittent tearing, photophobia, corneal enlargement, corneal clouding, optic nerve cupping, ocular enlargement |
| Ears, nose, oropharynx | |
| Otitis media | Bulging tympanic membrane |
| Thrush | White plaques on the buccal mucosa, tongue, or palate |
| Cardiovascular | |
| Anomalous origin of the left coronary artery | Cardiomegaly, heart failure |
| Heart failure | Feeding intolerance, tachycardia, poor perfusion, tachypnea |
| Supraventricular tachycardia | Pallor, irritability, poor feeding, cyanosis, restlessness |
| Gastrointestinal | |
| Anal fissures | Apparent on physical examination |
| Constipation | Passage of hard stools |
| Gastroenteritis | Vomiting, diarrhea |
| Gastroesophageal reflux | Vomiting, poor weight gain, feeding refusal, gross or occult blood in the stool |
| Gastrointestinal obstruction (eg, pyloric stenosis, intussusception, volvulus) | Vomiting (may or may not be bilious or forceful), gastrointestinal bleeding, forceful vomiting, abdominal tenderness, distension, right-sided sausage-shaped abdominal mass (intussusception), palpable "olive" (pyloric stenosis) |
| Inguinal hernia | Bulge in the groin area (may be intermittent), vomiting and abdominal distension may indicate incarceration |
| Genitourinary | |
| Meatal ulcer | Apparent on examination |
| Ovarian torsion | Feeding intolerance, vomiting, abdominal distension, fussiness/irritability |
| Testicular torsion | Acute testicular swelling and tenderness |
| Urinary tract infection | Fever, suprapubic tenderness, poor feeding, poor weight gain |
| Urinary tract obstruction | Abdominal distension (due to enlarged bladder), difficulty voiding, poor urinary stream, straining or grunting during voiding |
| Skeletal | |
| Fracture | Decreased movement of extremity, asymmetric Moro reflex, localized swelling and crepitation, increased pain response with movement of the extremity |
| Osteomyelitis or septic arthritis | Fever, decreased movement of extremity, asymmetric Moro reflex, increased pain response with movement of the extremity |
| Neurologic | |
| Abusive head trauma | Seizures, respiratory difficulty or apnea, retinal hemorrhages, cutaneous bruising, associated injuries |
| Meningitis | Fever, bulging fontanelle, lethargy, irritability, meningismus (often not present in infants) |
| Neuromuscular disease, CNS disorder, metabolic disease | Abnormal tone, muscular weakness |
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