A 12 Year Old Boy With Pain In His Legs At Night

A 12-year-old obese boy presents to your office complaining of bilateral leg pain that occurs only at night. His mother denies any pain during the day and reports he has not had a limp. The most likely diagnosis is
A) Slipped capital femoral epiphysis
B) Legg–Calve–Perthes disease
C) Osgood–Schlatter’s disease
D) Patellofemoral syndrome
E) “Growing pains”

Answer and Discussion

The answer is E. Growing pains

A diagnosis of “growing pains” must meet three criteria:
(1) the leg pain is bilateral;
(2) the pain occurs only at night; and
(3) the patient has no limp, pain, or symptoms during the day.

To inaccurately diagnose a limping child with growing pains can be dangerous, as the physician risks missing the underlying pathology. However, if a child does fit the criteria for growing pains, the parents should be reassured that this is a benign, self-limited process that occurs for unknown reasons.