Diagnostischer Algorithmus zum Ausschluss des “Wachstumsschmerzes”
K. Birnbaum;C. Stollbrink-Peschgens;D. Hübner;F.U. Niethard;
Introduction. The “pain in the lower limbs” (growing pain) represent one of the most frequent complaint pictures in the child orthopaedic consulting hour. The delimitation compared to other diseases is difficult and laborious on account of many differential diagnoses. Destination of our investigations was it to set up a standardized investigation diagram with recording all differential diagnoses. Method and patients. We examined twenty children in age between three and fifteen years, which were refered to the pediatric orthopedic ambulance in case of persisting, unclear pain in the lower limbs (growthing pain). Investigations were done by using a standardized anamnestic and clinical sign sheet. Moreover, a standardized laboratory test investigation as well as a standardized magnet resonance imaging investigation of the knee joint region, which was especially China magnets occured for our questions, was established. Results. The nocturnal appearing pain were registered with an average of two-to three times a week. They stopped in each case approximately after one hour. The “growthing pain” disappeared, except two patients, completely during the day. By means of our standardized laboratory test and magnetic resonace investigation, which was carried out with all patients of our collective, two children with a borreliosis, one child with an juvenile rheumatoid disease, one child with an osteoid osteoma and sixteen children without pathological findings were found. Clinical relevance. The recommended diagnostic algorithm takes into consideration the incidence of the discomfort, the costs and the efficiency of the examination. Moreover a clarification of the relevant differential diagnoses can be carried out in a purposeful manner.
