Differential Diagnosis for Leg Pain in a 5-Year-Old Female
Single Most Likely Diagnosis
- Growing Pains: This is the most common cause of leg pain in children, characterized by recurrent, bilateral leg pain that typically occurs in the evening or at night. The pain is usually mild to moderate and can be relieved with massage or heat.
Other Likely Diagnoses
- Muscle Strain: Overuse or minor trauma can cause muscle strain, leading to leg pain in children. This is more likely if the child has recently started a new physical activity.
- Shin Splints: Medial tibial stress syndrome, also known as shin splints, can cause leg pain in children who engage in running or jumping activities.
- Infection (e.g., Cellulitis, Osteomyelitis): Bacterial infections can cause leg pain, swelling, and redness. A history of trauma or recent infection may be present.
Do Not Miss Diagnoses
- Child Abuse: Leg pain can be a presenting symptom of child abuse, particularly if there are other suspicious injuries or inconsistencies in the history.
- Bone Tumor (e.g., Osteosarcoma, Ewing's Sarcoma): Although rare, bone tumors can cause leg pain and should be considered, especially if the pain is persistent, worsening, or accompanied by other systemic symptoms like weight loss or fever.
- Neurological Conditions (e.g., Peripheral Neuropathy, Spinal Cord Tumors): Certain neurological conditions can cause leg pain, numbness, or weakness. A thorough neurological examination is essential to rule out these conditions.
Rare Diagnoses
- Juvenile Idiopathic Arthritis: A chronic autoimmune disease that can cause joint pain, swelling, and stiffness, including leg pain.
- Legg-Calve-Perthes Disease: A rare condition that affects the hip joint, causing leg pain, limping, and limited mobility.
- Slipped Capital Femoral Epiphysis: A condition that occurs when the ball at the top of the femur slips out of place, causing leg pain, limping, and limited mobility.