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Joint Pains In Children
Leo Leonidas MD, FAAP
WARNING, WARNING, WARNING; This section is for my
Tufts University medical students. If you are a
"worrier" type or a very anxious parent, please talk
to your clinician about your child's problem or
symptoms, rather than reading this differential
diagnosis.
**
Joint pain is a common complaint of children. Fortunately most joint pains in children goes away by itself and are not serious. When there is significant joint pain called arthritis which is defined as swelling of a joint or limitation of motion accompanied by heat, pain, and tenderness laboratory test or X rays are necessary. One serious cause of arthritis is septic arthritis of the hip. This would require hospitalization and intravenous antibiotics and other tests.
Here are the multitude causes of Joint Pains:
ARTHRITIS ASSOCIATED WITH INFECTIONS
Bacterial Infections (Staph, Hemophilus, Strep, Neisseria gonorrhoeae)
Viral Infections (Parvovirus, Inf. Mono, Rubella, Mumps, Hepatitis B, Arbovirus, Adenovirus)
Mycobacterial
Mycoplasmal
Fungal
Reactive Arthritis (Salmonella, Shigella, Brucella, Yersinia, Campylobacter)
Parasitic Infestation
Syphilitic
Osteomyelitis
Lyme Disease
Toxic Shock Syndrome
Psoas abscess
RHEUMATIC AND INFLAMMATORY DISEASES
Lyme Disease
Inflammatory Bowel Disease
Jevenile Rheumatoid Arthritis
Henoch-Schonlein Purpura
Acute Rheumatic Fever
Systemic Lupus Erthematosus (SLE)
Serum Sickness
Dermatomyositis
Scleroderma
Sweet's Syndrome
Polyarteritis
Mixed Connective Tissue Disease
Ankylosing Spondylitis
Overlap Syndrome
OTHER INFLAMMATORY CONDITIONS WITH ARHTRITIS
Kawasaki Disease
Stevens-Johnson Syndrome
Infammatory Bowel Disease
Psoriatic Arthritis
Postimmunizations (MMR)
Scarcoidosis
Chronic Active Hepatitis
Sjogren Syndrome
Reiter Disease
Behcet Syndrome
Giant Cell Arteritis
Wegener Granulomatosis
TUMORS OR CANCER
Leukemia
Lymphoma
Neuroblastoma
Bone Tumors
ALLERGIC REACTIONS
IMMUNOLOGIC CAUSES
Subacute Bacterial Endocarditis
Ventriculojugular Shunt Infections
Immunodeficienty Syndromes
Complement Deficiency
METABOLIC AND ENDOCRINE CONDITIONS
Gaut
Hyperparathyroidism
Hyperlipoproteinemia
Gaucher Disease
Lipogranulomatosis
Throid Disorders
Mucopolysaccharidoses
Fabry Disease (Angiokeratoma Corporis Difusum)
Primary Hyperoxaluria (Oxalosis)
HEREDITARY DISORDER
Sickle Cell Disease
Hemophilia
Familial Mediterranean Fever
Stickler Syndrome (Hereditary Arthroophthalmopathy)
Marfan Syndrome
Ehlers-Danlos Syndrome
Homocystinuria
Hypermobility Syndrome
Hemoglobinopathy (sickle cell anemia, thalassemia, hemophilia)
ORTHOPEDIC CAUSES
Trauma Related
Mechanical Derangement (meniscal tear)
Chondromalacia of Patella
Legg-Calve-Perthes Disease
Slipped Capital Femoral Epiphysis
Osteochondritis Dissecans
Blount's Disease
OTHER CAUSES
Toxic Synovitis
Vitamin A Poisoning
Rickets
Cystic Fibrosis
Juvenile Episodic Arthritis/Arthralgias
Neuropathic Arthropathy
Whipple Disease
Thorn-Induced Arthritis
Villonodular Arthritis
Familial Mediterranean Fever
PSYCHOGENIC PAIN (school phobia, psychosomatic pain)
MIMICS OF ARHTRITIS
Tietze Syndrome
Hypermobility Syndrome
Subluxatin of Patella
Hypertrophic Osteoarthropathy
Carpal-Tarsal Osteolysis
Chondromalacia Patellae
Osteochondritis Dissecans
Idiopathic Chondrolysis
Popliteal (Baker) Cysts
Referred Pain
REFERENCES:
Signs & Symptoms In Pediatrics
2nd Edition, page 494
Tunnessen, Jr
Difficult Diagnosis In Pediatrics
Editor: Stockman, 1990, WB Saunders
Page: 338
Belly Pain Air Leaks From Lungs Acute Crying Back Pain Bed Wetting Big Lymph Node Big Spleen Blood in Urine Chronic Diarrhea Chest Pain Cough Coughing Up Blood Constipation Droopy Eye Enlarged Glands Eye Swelling Excessive Thrist Facial Paralysis Fainting Spell Feeding Problem GI Bleeding Headache Head Tilt Hives High ESR Hoarseness Joint Pain Limp Leg Pain Muscle Weakness Noisy Breathing Nose Bleeding Nose Obstruction Pyuria Recurrent Infection Red Green Urine Ringing in the Ears Scrotal Swelling Seizures Stiff Neck Swelling of the Parotic Gland Toe Walking Toeing In Toeing Out Unequal Pupils Vomiting Wheezing
Leo Leonidas, MD, FAAP
Assistant Clinical Professor in Pediatrics
Tufts University School of Medicine, Boston
Attending Pediatrician
Eastern Maine Medical Center, Bangor
BANGOR, MAINE: "First City with EBPP (Evidence Based Pediatrics for Parents) Website"
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