Discussions By Condition: I cannot get a diagnosis.

5 yr old son with leg pain on many pain meds. XRays, CT, bonescan..no diagnosis!

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: Anonymous
  • January 26, 2012
  • 04:57 AM

Please share any ideas or related experiences.

NOTE: our son is/was otherwise very active and healthy

An attempt to list the facts:

- approx a year ago, he complained of leg pain (mid-way between knee and ankle) at night, progressed to daytime complaints as well
- considered "growing pains" for months until pain started interfering with daytime activity and son was limping (turning toe outward to walk or just hopping)
- child reacts if we touch the sore spot - very specific spot
- pain was treated with over-the-counter anti-inflammatory for a few months eventually progressed to full-time meds including prescription Naprosyn (day & night)

A summary:

- XRay in Oct showed periosteal reaction along tibia in area of complaint

- XRay in Nov showed further periosteal swelling and *something* in the bone in the area
Ortho figured it was Osteoid Osteoma

- CT Scan was negative for Osteoid Osteoma.. radiologist figured it was an old stress fracture (unlikely that we wouldn't be able to identify a time/incident when a fracture could've occurred)

- Bone Scan negative for bone tumors of any kind.. a second radiologist thought possible fracture
- note: Orthopedic Surgeon & other second opinions disagreed with fracture diagnosis
- child was almost always in pain - just varying levels. Used Naprosyn (high dose) twice daily with Tylenol in between.

- December: Xray showed no periosteal reaction (likely due to high dose of anti-inflammatory) but *something* still visible on bone
- put a lower leg cast on it for 4 weeks (just in case it was a fracture...and hoping for pain relief).
- pain frequency decreased significantly - only needed Advil every couple of days! We were sure it must've been a fracture! Still had a few episodes of severe pain (seemed to correlate with higher activity days)

- Now: cast has been off for one week. He walks with an exaggerated limp (toe pointed almost 90 degrees outward). By the end of the day, he just hops on the other foot. His pain is becoming constant again and last night we had to go back to the prescription meds.

Any thoughts? Anything is appreciated. We don't want keep him on all of these pain-killers indefinitely but our child is in pain. If it's not Osteoid Osteoma or fractures (tried 4 weeks in a cast - a long time for little bones), what else should we be looking for? Any soft-tissue possibilities? ??

a concerned parent

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