The most common cause of recurring childhood musculoskeletal pain is termed “growing pains” (GP). The etiology and pathogenesis are unknown. There is an increased prevalence of migraine headaches in families with children with GP. This fact, and the sudden onset and severity of GP episodes, has led to speculation that GP may have a vascular component. Therefore, we investigated whether GP are associated with vascular perfusion changes, measured by technetium-99 methylene diphosphate (MDP) bone scintigraphy. Eleven patients with GP who underwent technetium-99 MDP bone scans were compared to 12 children who underwent bone scans for other indications. The uptake in the blood pool phase, static images, and blood pool phase/static image ratio were measured in the right mid-tibia region (painful among patients with GP) and right mid-femur (non-painful). Student’s t-test was used to compare these measurements at painful and painless regions among GP children, and to compare children with or without GP. There were no significant differences between children with GP and without GP in the blood pool, static images, and blood pool/static images in all localities. There were also no significant differences among patients with GP between painful regions and non-painful regions. We conclude that GP are not associated with vascular perfusion changes in painful regions as opposed to migraine headaches.
Bone scintigraphy Children Growing pain Vascularity
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We thank Omar Hamza for his technical assistance in the reading of the scans.
Naish JM, Apley J (1951) “Growing pains”: a clinical study of non-arthritic limb pains in children. Arch Dis Child 26:134–140PubMedGoogle Scholar
Oster J (1972) Recurrent abdominal pain, headache and limb pains in children and adolescents. Pediatrics 50:429–436PubMedGoogle Scholar
Bowyer SL, Hollister JR (1984) Limb pain in childhood. Pediatr Clin North Am 31:1053–1081PubMedGoogle Scholar
Sherry DD, McGuire T, Mellins E, Salmonsen K, Wallace CA, Nepom B (1991) Musculoskeletal pain in childhood: clinical and psychological analysis of 100 children. Pediatrics 88:1093–1099PubMedGoogle Scholar
Macarthur C, Wright JG, Srivastava R, Rosser W, Feldman W (1996) Variability in physicians’ reported ordering and perceived reassurance value of diagnostic tests in children with growing pains. Arch Pediatr Adolesc Med 150:1072–1076PubMedGoogle Scholar
Aromaa M, Sillanpaa M, Rautava P, Helenius H (2000) Pain experience of children with headache and their families: a controlled study. Pediatrics 106:270–275CrossRefPubMedGoogle Scholar
Gordon I (1996) Cerebral blood flow imaging in paediatrics: a review. Nucl Med Commun 17:1021–1029PubMedGoogle Scholar
Mirza M, Tutus A, Erdogan F, Kula M, Tomar A, Silov G, Koseoglu E (1998) Interictal SPECT with Tc-99m HMPAO studies in migraine patients. Acta Neurol Belg 98:190–194PubMedGoogle Scholar
Cauchy E, Chetaille E, Lefevre M, Kerelou E, Marsigny B (2000) The role of bone scanning in severe frostbite of the extremities: retrospective study of 88 cases. Eur J Nucl Med 27:497–502CrossRefPubMedGoogle Scholar
Bhatnagar A, Sarker BB, Sawroop K, Chopra MK, Sinha N, Kashyap R (2002) Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study. Eur J Nucl Med Mol Imaging 29:170–175CrossRefPubMedGoogle Scholar
Lalonde DH, Williams HB, Rosenthall L, Viloria JB (1984) Circulation, bone scans, and tetracycline labeling in microvascularized and vascular bundle implanted rib grafts. Ann Plast Surg 13:366–374PubMedGoogle Scholar
Al-Nahhas AM, Collins CD, Jawad AS, McCready VR (1994) Reversible findings of methylene diphosphonate bone scintigraphy in Raynaud’s phenomenon: case report and review of the literature. Eur J Nucl Med 21:258–260CrossRefPubMedGoogle Scholar
Hoffman J, Phillips W, Blum M, Barohn R, Ramamurthy S (1993) Effect of sympathetic block demonstrated by triple-phase bone scan. J Hand Surg 18:860–864Google Scholar
Grahame R, Bird HA, Child A (2000) The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 27:1777–1779PubMedGoogle Scholar
Spina A, Damato V, Losita R, Marzocco P, Narducci P, Zizzo L (1992) Brain SPECT and migraine in childhood. Acta Neurol 14:10–14Google Scholar
Lagreze HL, Dettmers C, Hartmann A (1988) Abnormalities of interictal cerebral perfusion in classic but not common migraine. Stroke 19:1108–1111PubMedGoogle Scholar
Aksoy FG, Lev MH (2000) Dynamic contrast-enhanced brain perfusion imaging: technique and clinical applications. Semin Ultrasound CT MR 21:462–477CrossRefPubMedGoogle Scholar