Clinical features:
(1) The patient experiences intermittent/recurrent episodes limb pain, typically in the legs (but may involve the back, shoulder, arm or groin).
(2) The pain often has a vague distribution/localization, and may be referred to muscles, bone and/or joints.
(3) Episodes of pain may waken the patient from sleep
(4) Episodes may be incapacitating and may interfere with daily activities.
(5) The patient has a normal physical examination with normal body temperature.
(6) Laboratory tests (including ASO, CRP, ESR, CBC) are normal.
The key to diagnosis is exclusion of other conditions:
(1) juvenile rheumatoid arthritis
(2) rheumatic fever
(3) leukemia
(4) osteoid osteoma
(5) Lyme disease
(6) osteomyelitis
(7) bone tumor
(8) osteochrondritis
(9) polymyositis or dermatomyositis
The diagnosis should only be made only after the patient has been observed for a sufficient period of time to make sure there is no evidence for an alternative diagnosis.
