A 16-year-old boy with lower extremity muscle wasting and pain
Bibliographic record
Abstract
A 16-year-old boy presented with 1-year history of left thigh pain that was dull in nature and lasted for several hours every day with minimal response to multiple analgesics (non steroid anti-inflammatory drugs, Acetaminophen, and Pregabalin). He denied any back discomfort, incontinence, muscle cramps, falling incidents, or sensory symptoms. There was no relevant past medical or family history. On physical examination, there was obvious wasting of the left lower extremity. Left mid-thigh circumference measured 42 cm as compared to right side 45.5 cm. And left calf measured 32 cm in comparison to right calf 35 cm (Figure 1). Deep tendon reflexes were +2 bilaterally with normal plantar responses. There was no evidence of increased tone. He had subtle weakness in left hip abduction/adduction and knee extension. The sensory exam was normal. Straight leg raise tests were both negative and there was no pain to palpation. ... The following radiologic images were done in order over a period of 6 months, X-rays knee and femur, MR spine, MR pelvis and thigh and MR head did not show any evidence of muscle, bone, vascular, lumbosacral plexus injury, or nerve lesion. Then, Doppler ultrasound for leg vessels was done and reported normal. Nerve conduction and electromyography studies were repeated twice over the same period and came back normal. After these extensive investigations and consultation with multiple specialists, a final imaging study and procedure revealed the diagnosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".