Defining Growing Pains

NewsBot · Jul 26, 2022

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Defining Growing Pains: A Scoping Review
Mary O’Keeffe et al
Pediatrics e2021052578.

BACKGROUND AND OBJECTIVES:
Up to one third of children may be diagnosed with growing pains, but considerable uncertainty surrounds how to make this diagnosis. The objective of this study was to detail the definitions of growing pains in the medical literature.

METHODS:
Scoping review with 8 electronic databases and 6 diagnostic classification systems searched from their inception to January 2021. The study selection included peer-reviewed articles or theses referring to “growing pain(s)” or “growth pain(s)” in relation to children or adolescents. Data extraction was performed independently by 2 reviewers.

RESULTS:
We included 145 studies and 2 diagnostic systems (ICD-10 and SNOMED). Definition characteristics were grouped into 8 categories: pain location, age of onset, pain pattern, pain trajectory, pain types and risk factors, relationship to activity, severity and functional impact, and physical examination and investigations. There was extremely poor consensus between studies as to the basis for a diagnosis of growing pains. The most consistent component was lower limb pain, which was mentioned in 50% of sources. Pain in the evening or night (48%), episodic or recurrent course (42%), normal physical assessment (35%), and bilateral pain (31%) were the only other components to be mentioned in more than 30% of articles. Notably, more than 80% of studies made no reference to age of onset in their definition, and 93% did not refer to growth. Limitations of this study are that the included studies were not specifically designed to define growing pains.

CONCLUSIONS:
There is no clarity in the medical research literature regarding what defines growing pain. Clinicians should be wary of relying on the diagnosis to direct treatment decisions.
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NewsBot · Jul 26, 2022

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Growing Pains in Children

NewsBot · Oct 26, 2022

Diagnosing growing pains in children by using machine learning: a cross-sectional multicenter study.
Akal F et al
Medical & Biological Engineering & Computing, 20 Oct 2022,

Growing pains (GP) are the most common cause of recurrent musculoskeletal pain in children. There are no diagnostic criteria for GP. We aimed at analyzing GP-related characteristics and assisting GP diagnosis by using machine learning (ML). Children with GP and diseased controls were enrolled between February and August 2019. ML models were developed by using tenfold cross-validation to classify GP patients. A total of 398 patients with GP (F/M:1.3; median age 102 months) and 254 patients with other diseases causing limb pain were enrolled. The pain was bilateral (86.2%), localized in the lower extremities (89.7%), nocturnal (74%), and led to awakening at night (60.8%) in most GP patients. History of arthritis, trauma, morning stiffness, limping, limitation of activities, and school abstinence were more prevalent among controls than in GP patients (p = 0.016 for trauma; p < 0.001 for others). The experiments with different ML models revealed that the Random Forest algorithm had the best performance with 0.98 accuracy, 0.99 sensitivity, and 0.97 specificity for GP diagnosis. This is the largest cohort study of children with GP and the first study that attempts to diagnose GP by using ML techniques. Our ML model may be used to facilitate diagnosing GP.
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NewsBot · Feb 23, 2023

Prevalence of growing pains in a general paediatric OPD: A descriptive, observational and cross-sectional study
Khuntdar, Bidyut K. et al
Journal of Family Medicine and Primary Care 12(1):p 117-122, January 2023. | DOI: 10.4103/jfmpc.jfmpc_1430_22

Context:
Growing pain (GP) is a common presentation in primary care settings.

Aims:
To find out the prevalence of GP and to observe its characteristics and associations.

Settings and Design:
General paediatric outpatient department (OPD).

Methods and Material:
Children coming to the general paediatric OPD of a tertiary centre in India between April 2019 and March 2020 for ‘chronic leg pains’ were screened with Peterson’s criteria. Patients with systemic illness were excluded. All received vitamin D and calcium supplementation. Patients with haemoglobin less than 11 gm% received additional 3 mg/kg iron supplementation. Then, patients were asked for follow-up.

Statistical Analysis Used:
Chi-square test.

Results:
A total of 333 children were diagnosed as GP out of the total OPD attendance of 26750. The prevalence was 1.24% and 72.7% among the children with chronic leg pain. Highest prevalence was in winter (1.74%). The mean age of the patients was 7.88 years. The mean duration of symptoms was 10.92 months. After 3 months, 267 patients could be followed up. Seventy-two out of 107 (67.3%) children, who received iron became symptom-free. Only 43 (28.8%) patients became symptom-free out of 160, who received only calcium and vitamin D3 and did not receive iron. The difference was highly significant statistically (P < 0.0001).

Conclusions:
The prevalence of GP in the OPD was 1.24% and 72.7% among the children with chronic leg pain. Iron supplementation along with vitamin D3 and calcium was associated with faster resolution of the symptoms.
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