Diagnostic algorithm for excluding the "growing pain"

Introduction. The "pain in the lower limbs" (growing pain) represent one of the most frequent complaint pictures in the child orthopaedic consulting h our. The delimitation compared to other diseases is difficult and laborious on account of many differential diagnoses. Destination of our investigatio ns was it to set up a standardized investigation diagram with recording all differential diagnoses. Method and patients. We examined twenty children in age between three and f ifteen years, which were refered to the pediatric orthopedic ambulance in c ase of persisting, unclear pain in the lower limbs (growthing pain). Invest igations were done by using a standardized anamnestic and clinical sign she et. Moreover, a standardized laboratory test investigation as well as a sta ndardized magnet resonance imaging investigation of the knee joint region, which was especially occured for our questions, was established. Results. The nocturnal appearing pain were registered with an average of tw o-to three times a week. They stopped in each case approximately after one hour. The "growthing pain" disappeared, except two patients, completely dur ing the day. By means of our standardized laboratory test and magnetic reso nace investigation,which was carried out with all patients of our collectiv e, two children with a borreliosis, one child with an juvenile rheumatoid d isease, one child with an osteoid osteoma and sixteen children without path ological findings were found. Clinical relevance. The recommended diagnostic algorithm takes into conside ration the incidence of the discomfort, the costs and the efficiency of the examination. Moreover a clarification of the relevant differential diagnos es can be carried out in a purposeful manner.