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Leg Pain
Leo Leonidas MD, FAAP
Warning: This section is for my 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.
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Idiopathic Leg Pain (growing Pain)
Trauma
1. Muscle or bone bruise
2. Fracture
3. Pathologic fracture
4. Osteoporosis
5. Muscle injection
Leukemia & Lymphoma
Bone Tumor
1. Malignant
Osteogenic sarcoma
Ewing
2. Benign tumor
Osteoid osteoma
Benign osteoblastoma
3. Metastatic tumor
Infection & Inflammation
1. Osteomylitis
2. Myositis
3. TB
4. Syphylis
5. Trichinosis
Miscellaneous
1. Hypermobility syndrome
2. Shin Splints
3. Scurvy
4. Stickler syn
5. Spinal cord tumor
6. Sickle cell dis
7. Hypervitaminosis A
8. Caffey dis
9. Gaucher dis
10. Melorheostosis
11. Engelman dis
12. Multiple epiphyseal dyspla
13. Foods
14. Renal Tubular Acidosis
15. Chemical preservatives
16. Ehlers Danlos
17. Pseudoxanthoma elasticum
Persistent bone pain with fever, think of Osteomylitis. However there are cases of Osteomylitis in children without a fever. (BMJ 2002;324:1380-1)
Persistent bone pain at one location think of bone cancer. CT or MRI of the area where pain is located should be done.
Most leg pains in children are not serious. However, any pain that persists should be checked by a clinician.
The initial testings for persistent leg pain are: CBC, ESR, and X-ray.
Leo Leonidas, MD, FAAP
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