Questions in the
Maternal and Child Health Forum
have been answered by
doctors from Henry Ford Health System.
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Subject: Re: unexplained leg pains My som is 11yrs. old. For the past year or so, he has expirenced leg pains mostly in his right leg the calf or thigh. The pains don't wake him at night and are not growing pains. His ped. doesn't know what they are caused by. The only test he has had for this is one x-ray which showed nothing. He has Epidermal Nevus syndrome, GERD, fine & gross motor delays, frequant migraine and tension headaches. My mother suggested lupus because a cousin or hers has it as an adult. The pain occurs when he has been active even after a short time, but also ocures when he has been watching tv or playing quietly. He is generaly not active, we can never get him to play outside, he had to quite Karate class last Feb. because of this & his headaches. Any ideas would be greatly apreciated. Thank you Cathy Dear Cathy : Growing pains may still be a cause although not in their typical presentation. As pediatricians , we are always cautious about diagnosing leg pains as growing pains as many pathologies can cause the same symptoms. Growing pains are usual between 3-12 years of age , the child is growing and developing normally , has intermittent aches ( dull) and pains alternating between the calves and thighs , poorly localized , no joint involvement , no limping , no disability or inflammation. Responds well to supportive measures including heat and massage. Systemic lupus is not a easy disease , it usually presents in teenage and young adult females , it has many presentations , there's no denial that you can have leg pains in lupus but that is not the major complaint. Criteria to diagnose SLE include ,ongoing fevers , a malar rash on the face like a butterfly , photosenstivity , mouth ulcers , arthritis , chest pain due to inflammation of the lung lining called the pleura , kidney problems with blood in urine , seizures , anemia , low platelet counts , and if a combination of these manifestations is present , then a tst for antinuclear antibodies can be done , which may help in diagnosing SLE . Leg length discrepency is another cause for muscles to become spastic due to the imbalance between the muscle groups trying to overcome the discrepency . This could be identified from a subtle limp and a comparison of leg length measurements. If the pain was shooting and sharp in nature mainly on the side of the thigh and leg , a compression of the nerve emerging from the vertebral column maybe a cause of leg pain . That would be detected from a good neurological examination and an X-ray of the spine. Malignancies can present with leg pain including leukemia , lymphoma , or bone tumors. Remember , the child would be very sick , having high fevers , pain would be severe enough to keep him awake at night , he would show signs of anemia and have an increased bleeding tendency . Bone X-ray can be helpful in bone tumors , and a complete blood count and smear would help rule out leukemias. There is no correlation between leg pains and GERD , migraines /tension headaches . Epidermal nevus syndrome has been associated with skeletal deformities . The causes of leg pain are numerous , namely any disease that can affect muscle , bone , soft tissue or nerves and vessels . Advise : if this pain persists , gets worse , has associated new symptoms or signs , a follow up visit to his pediatrician would be warranted. Thank you
keywords: Growing pains*( general pediatrics) , SLE*( rheumatology) , Epidermal nevus*( dermatology), Limp*(orthopedics) | |
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