Are you evaluating a pediatric patient with musculoskeletal complaints?

Does the patient have?

• diffuse bone pain that is more intense than expected for physical findings (disproportionate)?

• nocturnal bone pain that starts in the metaphysis?

• pain that is progressive in duration and intensity?

• arthritis or arthralgias which may be migratory?

• myalgias?

Does the patient have?

• hepatomegaly?

• splenomegaly?

• petechiae?

• lymphadenopathy?

• daily and/or prolonged fever?

• a loss of appetite?

• progressive anemia?

• thrombocytopenia?

• a normal white blood cell count initially?

• an elevated serum LDH?


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