Any ideas - leg pain in 6 year old - may not be Perthes ?

[didireallysaythat]

My son has complained of occasional pain behind the knee and was diagnosed by X-ray as having Perthes. But last year (and this year) the X-rays have been clear so the consultant has suggested a misdiagnosis - which I'm absolutely fine with. The thing is he still has the pain, nearly always in the evenings when he has done more exercise or bouncing than normal (which to me suggests probably NOT vitamin D defficiency). We are waiting for a paediatrician to check his blood results.

The consultant is a little reluctant to do a MIR and again I'm fine with this as it involves a general anaestethic and he doesn't know what this would show that Xray and bloods would miss.

So... oh wise mumnetters, is there something we've overlooked ? We are seeing our great GP next week and I would like to be able to bounce around a few ideas of what we do next with her if possible... maybe its the way he walks or something ? Etc...


Thanks !

[BeaWheesht]

How severe is the pain?

Ds (almost 6) regularly says he has sore legs but I've always just put it down to over exertion / growing pains.

[didireallysaythat]

It was enough to wake him up crying in the night when he was 4. Our GP maybe being over cautious but doesn't like to dismiss things as growing pains. The consultant may not be so cautious (I think he'd like us off the books) but why the right leg hurts not the left is harder to understand.

[lisad123]

Hyper mobility? Maybe a referral to physio would be a good idea.

[Viperidae]

DD had Osgood-Schlatter which causes pain after exercise but it is usually below the knee (at the front of the tibial tuberosity if we're being precise!) Apparently it is due to ligaments pulling on young soft bone whenever the knee bends

[didireallysaythat]

lisad123 I've been thinking that having a physio or podiastrist check the way he walks may be a good idea. The (orthopaedic) consultants and registrar have made him walk up and down the ward corridor in just his pants but the action maybe more subtle perhaps.

Viperidae - thanks I'll have a look.

I don't want my son to have a "thing" and it isn't impacting on his life a lot so I don't want to go looking on . But we have tried to limit the jumping activities (trampolines and bouncy castles) as he has more discomfort after 5 mins on them...

[drcrab]

Does he have a rash or a fever? Could it be a form of juvenile arthritis? My DS was diagnosed with that. He's 4.5.

[didireallysaythat]

Drcrab - I've not noticed a rash but he's had this for a couple of years so perhaps it wouldn't present that way? I'm hopeful that arthritis would show up with inflammation biomarkers from his blood test but the consultant didn't reveal what he was looking for (other than leukaemias).

Thanks for your suggestions - pls keep them coming. I think to get action I need to not a passive ie I need to suggest possibilities which the doctors can then tell me why they have discounted them...

[drcrab]

My gp did a whole load of blood tests. And the inflammation markers were elevated. About 80 for ESR (should be about 6-10??) and something high for CRP. White cell count slightly elevated too. Ferritin high.

Good luck with the investigations.