Table of contents:

1. What could be the causes of joint pain in a child?
2. Is it just joint pain or is there something else to look out for?
3. What can the doctor at the counselling centre do?
4. What about growth pains?

Older children may communicate that their leg or arm hurts. Younger children may have difficulty communicating that there has been pain. How then, in younger children, do you notice that a joint or limb pain has appeared? First and foremost, the child's parent will certainly take note of a change in behaviour, in the child's mood. There may be an apparent limp, a change in gait pattern or a reduction in the use of the painful upper or lower limb to a minimum.

What could be the causes of joint pain in a child?

The most common cause of pain is trauma in a child. In younger children it may not always be apparent that an injury has occurred, whereas an older child may say that he or she has bumped or fallen at school or kindergarten. Further causes can be:

• infections,
• rheumatological diseases,
• intestinal diseases,
• orthopaedic diseases (e.g. Perthes disease),
• osteoarthritis,
• metabolic diseases,
• congenital malformations or tumours.

Diagnosis of joint pain in children, photo: panthermedia

Is it just joint pain, or is there something else to look out for?

Your doctor will take a detailed history at your appointment, so it is worth considering any additional symptoms or complaints beforehand.

It is important to note whether there is pain alone, or whether there are other complaints, such as swelling of the joint, redness, increased heat. Whether the child has a fever or other systemic symptoms. Whether the pain is in just one joint or several, how long it has lasted, how often the pain occurs, when it passes, whether it awakens at night. Whether there has been no recent trauma, whether there is a family history of rheumatological diseases, whether there has been a recent infection in the child.

If there has been trauma and pain, go to A&E to rule out a fracture in the child. If, in addition to joint pain, there have been other systemic complaints, e.g. fever, diarrhoea, or the child has had a recent respiratory infection, pain has awakened during the night, urgent medical advice is needed.

Joint pain can also be a symptom of other ongoing diseases in the body, so it is advisable to consult the paediatrician as to the complaints present.

What can the doctor at the clinic do?

The basis of any visit, irrespective of the problem presented by a parent with a child, is a detailed history, which is extremely important to begin an appropriate diagnosis. During the interview, the doctor will ask about:

• possible recent trauma,
• past infections,
• chronic diseases,
• illnesses in the family.

Joint pain in children: causes, photo: panthermedia

Questions about pain and other symptoms are also an important part of the history. If there is an injury and a fracture is suspected, the child may be sent for a surgical or orthopaedic consultation.

Completing the history is an examination of the child together with attention to the joints that give complaints. Additional symptoms during the examination of the child are important information for the examiner.

In the outpatient clinic, the paediatrician may order additional laboratory tests covering basic parameters such as:

• CBC,
• CRP,
• additional biochemical tests,
• tests for rheumatological diseases or tests for infections.

With regard to the ordering of imaging studies, an X-ray may be performed in the case of a fracture, for example, or a Medical US of the joint or an MRI scan may be performed.

Once the results have been received, depending on the need, the child may be referred for further diagnostics within the outpatient clinic or hospital admission.

What about growth pains?

Growth pains most commonly occur in children aged 2-3 years and between 8 and 12 years. The complaints usually occur in the evenings or at night and affect only the lower limbs and not the upper limbs. It can occur in one leg or both legs. Usually the child reports pain not in the joint area, but below the knee joints. Growing pains often affect children who are physically active.

Growing pains in children, photo: panthermedia

With complaints, it is worth consulting a doctor who, after examination and differential diagnosis, will be able to answer the question of whether these are growth pains or whether it requires further, detailed diagnosis.

Joint pains in a child should not be underestimated. They can be a symptom of many diseases, which, if detected early, can be treated appropriately, and the reduction of pain in the child and the return to full health is extremely important for the young person's further development and carefree exploration of the world.