Abstract

A previously healthy 13-year-old female presents to the pediatric rehabilitation outpatient clinic with a complaint of chronic pain in the left lower extremity. The pain began at age seven without trauma or inciting event and has insidiously worsened. The patient’s mother reports her having been seen three years prior by an outside provider who ordered imaging that was within normal limits and was diagnosed with “growing pains”. Physical exam reveals no paresthesia or weakness in the lower extremity as well as no asymmetry, swelling, or bump. No pain could be elicited with resisted ankle eversion, inversion, dorsi or plantar flexion. Positive findings include a mild antalgic gait and pain to palpation of the soft tissue distal and posterior to the fibular head.

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