Vulvar Discomfort in a 10-year-old Girl

A 10-year-old girl presents to a midwestern adolescent medicine (AM) clinic for evaluation of a labial lesion. Her medical history is significant in that she has entered puberty but is still premenarchal. Her psychiatric history is noncontributory. She initially notes a 1-day history of genital pain that began during a dance recital. She is a competitive jazz dancer. The following day, her mother noticed that she had a wide-based gait when...