Maternal Expert Forum
unexplained leg pains
About This Forum:

Patient medical question and answer from The Maternal and Child Health Forum. Health topic area and articles about newborn care

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

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 :
  : It would be helpful if you can describe his leg pains , are they dull , sharp , pulsating , do you see any swelling in the surroundings especially the joints , is there any tenderness when you touch his leg at the time he has the pain , can he localize the pain , is it always in the same location , where exactly on his leg does it hurt . Can you describe his gross and fine motor delay ? it would help to identify any muscle spasm . Does he limp when he has / does not have the pain , any associated fevers ?
  : Does he have good control of his bladder and bowel movements ? How much does he weigh ?
  : 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
  : L.M.
  :
  : Disclaimer : this information is provided for academic purposes only.
  : keywords: Growing pains*( general pediatrics) , SLE*( rheumatology) , Epidermal nevus*( dermatology), Limp*(orthopedics)

    RE: RE: leg pains,
   Thank you for your quick response. My son weighs 67lbs, 4"5". The leg
   pains are an ache, on the calf and/or the front, back, and inner thigh.
   He has limped with the pain but not usually. He is able to walk and run
  with the pain, but I discourage this as I don't want the pain to worsen.
   On 9-13-98 we went to an amusment park, being there apx. 1/2 hour, his
  leg started to hurt, this continued all day & at night, the next day and
   even this morning 9-15-98 he is complining of the pain. He does not have
   a fever, swelling, redness, or hot spots. I see no leg size discrepancy,
   his motor delays are mild low muscle tone, and muscle strength,he still
   can't cut food or open candy wrappers etc . has problems with most snaps
   and some zippers, has a seizure disorder he has had an x-ray of his spine
   to check for scholiosis, which he doesn't yet have,though his lower back
  appears to curve in a little too much. Could this be a form of mild
   cerebral palsy? or muscular distrophy?How would we find out?
    Thanks again
    Cathy

Dear cathy :
I am not sure if the X-rays that were done included the hips. It's worth checking for what is called " slipped capital femoral epiphysis" or SCFE.
This may present with similar symptoms , in the form of referred pain from the hip, and is diagnosed by a bilateral hip X-ray.
A second opinion from a pediatric neurologist , with a complete neurological physical examination can help identify the difference between muscular dystrophies ( and there are many forms) or a very mild form of cerebral palsy. Cerebral palsy children , even in their mildest forms , suffer from increased muscle tone , tiptoeing and hypersensitive joint reflexes( hyperreflexia).
Please keep us posted and thank you
L.M.





Related Discussions
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank