10 yr old sclerotic bone and pain

My son is ten years old. Last March he injured his knee at school and I took him for xrays. Nothing was broken but a few days later, I got a call saying his femur had sclerotic bone growth. He went to an orthopedics doctor and after examining his legs and xrays, she told me both of his femurs have the same growth pattern.

He had been having "growing pains" for the last two, maybe three years. Enough that one leg will frequently wake him at night and I have to rub it until he sleeps again. Sometime I have to give him tylenol or advil. He's been tested for juvenile RA and he does not have that.

The last 4 days, he's been complaining about the same leg a lot. When we tucked him in tonight, he accidentally bumped his knee on my elbow and cried, out right tears and curled up in pain. I have never seen him in such agony. (Not even when he broke his wrist a year ago, he didn't shed one tear).

I am going to try and get him back into the specialist, but does anyone have any insight? Is it normal for sclerotic bones to be so tender??

Thanks

[S. Kaul, MD]

Hi there!

Yes, osteosclerosis may tend to be painful. Treatment is largely symptomatic unless associated with other conditions such as infections/ inflammations, fractures, nerve compression etc. Without knowing the relevant clinical details it would be difficult for me to comment further. I would suggest discussing the situation in detail with your orthopedician.
Hope this information helps.

Take care!

[kitteh709]

Thanks so much for taking the time to comment. The only test he's had is an xray and this is the report..

"There is an atypical pattern in the distal left femoral metaphysis which demonstrates an irregular sclerotic patternnot present in the proximal tibial metaphysis.This may be the site of remote trauma or other etiologies. If symptoms are persistent and related to this area then correlation with muclear medicine bone scan or MRI is suggested to exclude a more aggressive lesion."

He did see an orthopedician and she said she would follow him. It seems like sometimes its very painful and then it settles. This time is the first time that we have seen it swollen and warm since it started. He has an appointment to see her on Sept 16. In the meantime, I am treating it with ice, advil and a knee brace to protect it from bumps..

[kitteh709]

Also, what causes this type of bone growth in a relatively healthy child?

[S. Kaul, MD]

Hi again!

Well, if there was no other lesion seen with sclerosis this is likely to be either due to trauma or an infarct and may get better with time. All it needs is to be followed up regularly for regression, increased size or development of multiple lesions. In the later case, one might have to look for a more aggressive pathology such as infections, growths etc. that could cause sclerosis. Meanwhile braces, ice-packs and NSAIDS are appropriate for pain relief.
Hope this is useful.

Take care!

[kitteh709]

Thanks so much! Having a voice of reason is immensely helpful.

When he originally saw the orthopedician, she xrayed both knees and told me there was similar growth pattern on the other femur as well.

He hasn't broken any bones other than his wrist. And no trauma that we were aware of. It seems to be settling down again, less pain etc. WHich seems to happen with it frequently. I'll certainly post again if anything else pops up that has me worried.

Thanks for all the insight and help. It's rough to have a child and wonder what is wrong.

OH! As a side note, should he be allowed to participate in normal activities? He wants to join karate, but I am honestly worried if that will aggravate it.

Thanks!

[S. Kaul, MD]

There is no reason to restrict activities unless he himself feel uncomfortable.