1) Growing pains – common in 3-5yrs and 8-12 yrs, recurrent pain in the muscles, bilateral, commonly calf and thigh muscles, normal joints and bones, usually evenings, occasionally night, no point tenderness anywhere in the limbs, no limp during the day. Mx – gentle massage, paracetamol, stretching, heat pads.
2) Traumatic pain – sprains and strains
3) Paellofemoral pain –
4) Stress fractures
5) Osteochondrosis
6) Hypermobility Syndrome – age of onset 3-10 yrs, aching after physical exertion, fatigue, easy bruising, tense or stiff joints, worsening pain during the day and less after rest, comorbid with hernias, varicose veins, flat feet, foot ache, backache, recurrent joint dislocation, common signs are – can put hand flat on the floor while knees kept straight, can hyperextend elbow, can hyperextend knees, can hyperextend thumbs onto the forearm, can hyperextend the little finger 90* to the hand, Mx – muscle strengthening exercises, muscle relaxation exercises, NSAIDs and analgesics, splints and bandages,
7) Rickets – around 1 yr, growing pain, bow legs, bone pain, wrist swellings, chest swellings, bow legs, rachitic rosary, hot-cross bun sign, frontal bossing, delayed motor milestones, hypotonia, bone deformities – wrist waisting, lateral ot anterior bowing of tibia, femur, rickety rosary – costochondral junction swellings, Harrison’s sulcus, delayed closure of fontanelles or large fontanelles, craniotabes – softening of skull bones, usually in parietal or occipital bones, ping-pong ball sensation on firm pressure, an early sign, frontal and parietal bossing – due to longstanding deficiency, recurrent respiratory infections due to impaired immunity, convulsions, apneic attacks, irritability, carpopedal spasms from hypocalcemia in very young infants,
8) Normal skeletal growth variants – Osgood-Schlatter syndrome, Sever’s disease