Differential Diagnosis for Bilateral Ankle Pain in a 3-Year-Old Female
Single Most Likely Diagnosis
- Toddler's fracture or accidental trauma: Given the age of the patient, a common cause of bilateral ankle pain could be related to minor trauma or fractures that are common in toddlers due to their active nature and frequent falls.
Other Likely Diagnoses
- Viral infections (e.g., viral arthritis): Viral infections can cause joint pain and swelling in children, and the ankles can be involved.
- Growing pains: Although typically more common in the legs, growing pains could potentially cause ankle discomfort in some cases.
- Juvenile idiopathic arthritis (JIA): An autoimmune condition that can cause joint pain and swelling, including in the ankles, though it's less common in very young children.
Do Not Miss Diagnoses
- Septic arthritis: A serious bacterial infection within a joint that requires immediate medical attention to prevent long-term damage.
- Osteomyelitis: A bone infection that can cause pain, swelling, and redness in the affected area, including the ankles.
- Child abuse: In cases of unexplained or recurrent injuries, child abuse must be considered and investigated.
Rare Diagnoses
- Neuroblastoma or other bone tumors: Though rare, certain types of cancer can cause bone pain, including in the ankles.
- Hematologic disorders (e.g., sickle cell disease): Certain conditions can cause vaso-occlusive crises leading to pain, including in the ankles.
- Inflammatory bowel disease (IBD): Can sometimes present with extraintestinal manifestations, including joint pain and arthritis.