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Decreased Bone Speed of Sound in Children with Growing Pains Measured by
Quantitative Ultrasound
ORIT FRIEDLAND, PHILIP J. HASHKES, LUTFI JABER, HERMAN A. COHEN, ALON ELIAKIM, BARUCH WOLACH, and YOSEF UZIEL ABSTRACT. Objective. The most common cause of recurring childhood musculoskeletal pain is termed growing pains (GP). We hypothesized that GP may represent a local overuse syndrome and therefore may be associated with decreased bone speed of sound (SOS) measured by quantitative ultrasound (US). Methods. We studied 39 children with GP. Bone SOS was measured by US in both mid-tibial and radius bones according to a validated protocol. Unpaired Student t test was used to compare patients and norms of healthy controls. Results. Tibial SOS was significantly reduced in children with GP compared to controls (Z score –0.546 for boys and –0.891 for girls; p = 0.004, p < 0.001, respectively). Radius SOS was significantly reduced only in girls with GP (Z score –0.692, p = 0.006). No correlation was found between bone SOS and various demographic and clinical factors besides the child's ethnicity and body mass index. Conclusion. Bone SOS was significantly reduced in children with GP, especially in painful tibial regions. GP may represent a local overuse syndrome. (J Rheumatol 2005;32:1354-7) Key Indexing Terms:
CHILDREN From the Department of Pediatrics, Pediatric Rheumatology Service, Meir Hospital, Kfar-Saba, Tel-Aviv University, Tel Aviv; Taibe Child Health Center, Taibe; Petach Tikva Child Health Center, Petach Tikva, Israel; and Section of Pediatric Rheumatology, Department of Rheumatic Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA. Supported in part by Mrs. Rachel Fridman in the memory of her late brother, the rheumatologist Dr. Gregory Mintz. O. Friedland, MD, Instructor; A. Eliakim, MD, Senior Clinical Lecturer; B. Wolach, MD, Professor of Pediatrics, Department of Pediatrics, Meir Hospital; P.J. Hashkes, MD, MSc, Section of Pediatric Rheumatology, Department of Rheumatic Diseases, Cleveland Clinic Foundation; L. Jaber, MD, Professor of Pediatrics, Taibe Child Health Center; H.A. Cohen, MD, Senior Clinical Lecturer, Petach Tikva Child Health Center; Y. Uziel, MD, MSc, Senior Clinical Lecturer, Department of Pediatrics, Pediatric Rheumatology Service, Meir Hospital. Address reprint requests to Dr. Y. Uziel, Department of Pediatrics, Meir General Hospital, Kfar-Saba, 44281 Israel. E-mail: uziely@zahav.net.il Accepted for publication February 7, 2005. |