Juvenile nocturnal foot pain

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I have seen a young 4 year old boy recently whose mother reported that he was waking up at night screaming, complaining of pain in his foot. It varies in which foot is painfull. Examination shows no abnormalities and all imaging appears normal. There is no evidence of any circulatory problems. It is not every night it occurs but the boy is very distessed when it does occur. Anyone got any ideas?

 

Sounds like it could possibly be an atypical presentation of growing pains

Also see this discussion

 

Is the pain more likely to occur after the child has had a lot of activity during day?

 

How long as it been going on? have any treatments been tried? Does it only happen on growth
Spurts? I would also consider other imaging modalities if not been performed already. Maybe speak to GP to bone scan ( nuclear and/or) CT if not already been performed. friend of mine (child) been experiencing real bad night pain turned out to be a tumour. Not in the foot.Appears they are worse at night apparently!

Maybe a bit excessive but no harm I being cautious IMO...

I hate typing on my iPad!

 

I'm with tough spiders, while is may just be what Craig said, I am always very cautious about discounting night pain.

Kids get night terrors and aching legs etc, some may be pyschological and require a nice cuddle and back to bed, some may be biomechanically related. There are also the more rare and serious tumours that start in the leg though you mention that imaging is normal, has the leg also been excluded?

I'm also not sure where you are located and what the weather is like. I swear I have had a run the last few weeks of kids with abnormal aches and pains but the weather has been +35-40 degrees and they haven't been drinking enough. Same sometimes goes if we have a cold snap and the kids have their foot outside the bedcovers.

Anyways, there are few things for you to go on but given how distressing it sounds from your explanation, I think a medical check up is the first place to start.

 

No. We could find no correlation with different activity

 

Found out today that MRI was NAD

 

We're in the UK. Extremes of temperature are rare but the hydration question I haven't thought of. Thanks for that.

 

Thank you for your link to the discussion. Although I have never come accross these symptoms before It does seem to an established complaint. I would hae thought tho' that Kohlers disease would show through imaging.