10 year old with leg and thigh pain

[FustratedinCARY]

My 10 year old is having intermittent leg and thigh pain, he is lethargic, angry against his older brother. But, so far he has no fever, normal labs, x-ray and mri are normal, too. Also, when he was 6 years old he had been diagnosed as having systemic JRA - 3 weeks at Duke Hospital and lots of steroids later, it took him a year to recover and now out of the blue he has unexplained leg, thigh and hip pain. This has been going on for several months. We are waiting for a Lyme test to come back. Also, someone brought to our attention a theory by Dr. Sherry in Philly (chop) where he believes the pain signal was distorted as a result of a traumatic event - such as arthritis.

Help! Any suggestions?

[qwertyuiop123]

Is it in one or both legs? Does his spine seem to curve at all, side to side or front to back? Does he have any other symptoms? Is this similar to when he was diagnosed as having systemic jra? Any family history of... well.. anything? What exactly have they mri, xray, and cat scanned?

[FustratedinCARY]

Thanks Quewrty.

Replies are bolded

Is it in one or both legs? Does his spine seem to curve at all, side to side or front to back?

Both legs, plus shoulders. Spine curve is normal.

Does he have any other [COLOR=blue! important][FONT=verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif][COLOR=blue! important][FONT=verdana, geneva, lucida, 'lucida grande', arial, helvetica, sans-serif]symptoms[/FONT][/FONT][/COLOR][/COLOR]?

Mild depression when the pain is bad. Doesn't want to even play soccer - his favorite sports. "Says, it's too much running" Sometime, he says it hurts all over. When he is feeling better, his attitude
and moving around is much better. But, he has more pain, then
feeling good occcasionally.


Is this similar to when he was diagnosed as having systemic jra?

This time no fever, no blood inflamation. So, it's similar. But, different. Originally, his whole body blew up and he had a high fever for 2 weeks. Also, a distended belly - he looked pregnant. It was bad!!


Any family history of... well.. anything?

Grandmother had growing pains.

What exactly have they mri, xray, and cat scanned?

MRI and cat scan - x-raying hips and legs

Thanks

Fustrated

[nikiski1]

I was wondering what kind of pain is it, burning, sharp shooting ect. IS there any changes in the skin? You mentioned about the Dr Sherry believing the pain signals are disorted. I know a great deal of this doctor, and usually what he means about the signals due to trauma he is thinking RSD. That is how I know of him, as I have RSD. I really hope that this isnt the case as RSD is a really painful disease. It can be caused from just bumping yourself to surgery, and sadly there is no cure, if it is caught 3 months into it then there is a chance for remission.

[Kiera]

I was thinking about his lower spine as well. Ask to have a MRI of his lumbar and sacral region. Pain is often felt in the thigh, leg and ankle when there is trouble in this area!

Wishing you the best...

Kiera

[FustratedinCARY]

I was wondering what kind of pain is it, burning, sharp shooting ect. IS there any changes in the skin? You mentioned about the Dr Sherry believing the pain signals are disorted. I know a great deal of this doctor, and usually what he means about the signals due to trauma he is thinking RSD. That is how I know of him, as I have RSD. I really hope that this isnt the case as RSD is a really painful disease. It can be caused from just bumping yourself to surgery, and sadly there is no cure, if it is caught 3 months into it then there is a chance for remission.

He pain is described as throbbing. But, when it is at it's worst. He loses strength and he walks stiffly and slowly.

Regarding Dr. Sherry. If it is RSD, we were encouraged that it could be fixed throigh intensive excercise. But, your comments are not so encouraging. His skin is normal. Also, I left off his Rheumy saw no Arthritis on his physical exam.

[FustratedinCARY]

I was thinking about his lower spine as well. Ask to have a MRI of his lumbar and sacral region. Pain is often felt in the thigh, leg and ankle when there is trouble in this area!

Wishing you the best...

Kiera

Thanks, Kiera. He had an MRI and X-Ray. Both were normal. They though his steroid treatment had zapped his hips. ( AVN) But, no problems there.

[qwertyuiop123]

What exactly did they xray and mri? His spine, his hip, his knee, his ankle?

[FustratedinCARY]

What exactly did they xray and mri? His spine, his hip, his knee, his ankle?

Spine, hip amd legs

[qwertyuiop123]

Hip pain
Hip stiffness
Abnormal gait
Buttock pain
Groin pain
Thigh pain
Restricted internal rotation

Do these symptoms sound about right? If so here's a link http://wrongdiagnosis.com/o/osteoart...m#symptom_list

I also found this on a website, it wasn't an entire article, it was just an abstract.
Summary

Objective

We sought to determine whether sequence variations in cartilage collagen genes are associated with primary, early-onset osteoarthritis (OA). Methods


The cartilage collagen genes, COL2A1, COL9A1, COL9A2, COL9A3, COL11A1 and COL11A2, were screened for sequence variations in 72 Finnish probands and one US family with primary early-onset hip and/or knee OA. In addition, allelic association studies were performed using six to 12 common polymorphisms from each gene by genotyping 72 OA patients and 103 controls. Results


Altogether 239 sequence variations were found, of which 16 were not present in the controls. Seven of the unique variations, four in COL11A1, two in COL11A2 and one in COL2A1, were studied further, because they resulted in the substitution of conserved amino acids or were predicted to affect mRNA splicing. Co-segregation of a sequence variation and the phenotype was found in all four families available for study. Association analysis failed to identify any common predisposing alleles. Conclusions

Early-onset OA demonstrates locus and allelic heterogeneity since the identified variations were in three different collagen genes and each of the six probands had a different mutation. It is also possible that some OA cases represent the mild end of the chondrodysplasia phenotypic spectrum. The major susceptibility alleles in this form of OA, however, remain to be identified.

I'm wondering if these same genes might be responsible for rheumatoid arthritis?
It is also possible that if your son injured his hip or knee awhile ago, it could have caused osteoarthritis now.