Growing pains?


Growing pains?
Childhood aches may be symptom of more serious illness
By ED CULLEN
Advocate staff writer
Published: Jan 8, 2007

A child’s “growing pains,” mysterious aches and pains that doctors don’t fully understand, occur in fewer than half of American children.
Often, any pain that a parent can’t immediately associate with an obvious cause is passed off as a “growing pain.”

Coming on in childhood or adolescence, so-called growing pains can be the symptoms of serious illness, one of more than 100 rheumatic disorders or some other serious disease, said Stephen Lindsey, an Ochsner Health System physician who specializes in rheumatism.

Arthritis is among the approximately 100 rheumatic diseases that cause swelling and pain in the joints.

While most “growing pains” may be just that and will eventually go away, Lindsey sees an average of 12 children a month who are suffering serious illnesses that won’t just go away.

“Growing pains” may come on late in the day, especially if a child has been particularly active. The pains may be severe enough to awaken a sleeping child.

The pain isn’t specific to joints, occurs mainly in the legs and may come and go for months.

The only way to rule out something serious, Lindsey said, is a physician’s exam, lab work and X-rays.

One recent afternoon, three of Lindsey’s young patients and their parents gathered to talk about “growing pains” that turned out to be serious illnesses requiring immediate attention.

Sarah Rodriguez, now a 14-year-old student at Galvez Middle School, was practicing her softball pitching when she slipped on rain-slick grass.

“I was in my windup,” she said. “Slipped and fell. I couldn’t get up.”

Rodriguez had dislocated her hip but didn’t know it.

The next day, her foot cold and almost black, Rodriguez went to her pediatrician. The teenager, who’s double jointed, thinks her hip popped back in of its own accord.

Almost six weeks went by without the foot regaining normal color and sensation. Her lower leg swollen, Rodriguez spent four days at Our Lady of the Lake Regional Medical Center where she got a diagnosis of Reflex Sympathetic Dystrophy Syndrome or RSDS.

“It’s not common, but we see it,” Lindsey said.

It’s likely that the fall Rodriguez took on the wet grass was the start of her RSDS, Lindsey said.

A series of six nerve blocks and six weeks of high dose steroids have left Rodriguez with some pain but the ability to get around again. Physical therapy helped mobilize the young woman’s hip and leg.

Nerve blocks are shots of long-acting anesthetics that block nerve overstimulation. Steroids decrease inflammation.

“I’m not giving up on my dream,” said the teenager who describes her pitching as having “speed potential” with good control and ball movement. “I want to pitch in college.”

“The longer you delay treatment, the better chance of atrophy (muscle loss) or chronic pain,” Lindsey said.

Two years ago, Laurie Petty of Gonzales noticed that Ashlynn, her 3-year-old daughter, seemed to have trouble walking upon awaking in the morning.

“She’d scoot out of her room on her hands and bottom,” the young mother said. “I thought she was doing it to get attention.”

By the time Ashlynn’s dad, Toby, got home, there was nothing Laurie could show her husband about their daughter’s odd morning behavior.

“By the time I got home,” said Toby Petty, “she was running around playing.”

The weekly shot Laurie Petty now gives Ashlynn to control the child’s rheumatoid arthritis in knees, ankles and right elbow makes the little girl “a very healthy 5-year-old,” Petty said.

Ashlynn put an exclamation point on her mother’s statement with an athletic leap from the examination table.

“Juvenile rheumatoid arthritis involving five or more joints used to frequently lead to crippling by the time the child was 10,” Lindsey said.

Lindsey diagnosed Anna Claire Gossen, 6, of Rayne with juvenile monoarticular rheumatoid arthritis. Anna Claire has arthritis in her left elbow.

“When I first saw her, she had a 45-degree bend in her elbow,” Lindsey said. “Now, it’s only 18 degrees from full extension. I think we’ll get her a little better and she should go into remission at puberty. We may only get her back to 15 degrees, but she’ll be able to do what most teenagers can do.”

Anna Claire’s dad, Jason, made the discovery that something was wrong.

“We were at the beach,” the little girl said. “My daddy was putting sunscreen on me and noticed my arm was bent.”

“One elbow, the left, was swollen,” Jason Gossen said.

Children often adapt to balky joints, Lindsey said.

“It took a while to diagnose,” said Anna Claire’s mother, Amy. “We were sent to an orthopedist who thought it might be a fracture, that maybe she’d fallen and kept going and it healed itself.”

But that wasn’t the case.

“I want parents to mention these pains to their family doctors when their children are getting their physicals,” Lindsey said. “I don’t want parents saying, ‘Oh, it’s growing pains,’ and missing something serious. If the parents aren’t satisfied with what the doctor says, they should get another opinion.”

Click Here For The Original Article Online.

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