Differential Diagnosis for 10-year-old Female with Bilateral Leg Pain
- Single Most Likely Diagnosis
- Growing pains: This is the most common cause of bilateral leg pain in children, characterized by recurrent, non-inflammatory pain in the legs, typically occurring at night.
- Other Likely Diagnoses
- Overuse injury: Given the age, the patient may be involved in sports or physical activities that could lead to overuse injuries such as shin splints or stress fractures.
- Juvenile idiopathic arthritis (JIA): An autoimmune disease that can cause joint pain and swelling, although it typically presents with other symptoms like morning stiffness and joint swelling.
- Vitamin D deficiency: Can cause muscle and bone pain, especially in children with limited sun exposure or inadequate dietary intake.
- Do Not Miss Diagnoses
- Osteosarcoma or other bone tumors: Although rare, these can present with bone pain and must be considered to avoid delayed diagnosis.
- Leukemia: Can cause bone pain due to marrow infiltration, and it's crucial to diagnose early for effective treatment.
- Sickle cell disease: If the patient has a history of sickle cell disease, vaso-occlusive crises can cause severe leg pain.
- Neurological conditions (e.g., peripheral neuropathy, spinal cord tumors): Can cause leg pain and must be considered, especially if there are other neurological symptoms.
- Rare Diagnoses
- Fibromyalgia: A chronic condition characterized by widespread muscle pain, although it's less common in children.
- Reflex sympathetic dystrophy (RSD): A rare condition causing chronic pain, usually after an injury.
- Eosinophilic granuloma: A rare condition that can cause bone pain due to Langerhans cell histiocytosis.
- Chronic recurrent multifocal osteomyelitis (CRMO): A rare inflammatory bone condition that can cause recurrent episodes of bone pain.