Doctors Lounge - Rheumatology Answers
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Forum Name: Rheumatology Topics
Question: foot pain
|swat - Fri Jul 02, 2004 10:21 pm||
My son is 13 years old. For the last two years he has complained of a pain originating in the outside heel below the ankle of his foot. He complains that the pain radiates up the leg like a lightening bolt and then leaves him unable to walk without a limp. He refers to it as "dead foot". I have seen him walk down 3 steps and fall the rest of the way. I have seen him walking along and drop to his knees. He limps most of the time and this problem can affect either leg but is primarily in the right leg. It is random and inconsistent. He never knows when it will occur. Two months ago I noticed the same type of pain in my left inside heel. I too struggle daily with bearing weight on my foot due to lightening bolts of pain. We both tend to bruise easily and while I am grossly overweight, he is not. A recent urinalysis for my son revealed microscopic traces of blood in the urine. A nerve conductivity test showed a loss of conductivity in both lowe legs and a spinal MRI is scheduled for in July. I have also seen him walk along and jsut drop an item he was holding in his hand without realizing he had dropped the item. Do you have any suggestions as to what I as his mother should be doing? Which doctor or test should I request? I am very frightened.
|Dr. Russell M - Mon Jul 12, 2004 1:31 pm||
Limping, at your son's age, makes me think of the entitiy called 'slipped capital femoral epiphysis,' which is the term for a commoner hip disorder in adolescents. It is usual for children with this hip disorder to complain of pain in the knee and to limp. An X-ray of the hip should help identify this. Has it been done?
The easy bruisability you share with your son, would want me to rule out hemophilias, the clotting disorder, which again can cause bleeding into the joints to cause symptoms. But I assume your doctor would have run a check on the bleeding tests.
The shooting pains are more in tune with neuropathic pain, and the origin at the spinal level should indeed be checked out, an MRI of which is already underway.
It is frequent for children to bruise their kidneys from falls and other traumas, which might result in microscopic hematuria (blood in the urine). But it would be prudent to rule out kidney disorders by an ultrasound, to find out if the kidneys are vulnerable to mildest shakes from trauma, which usually is the case in congenital malformations of the kidney. Then again people with severe hemophilias can present with blood in the urine.
The good part is that we have already begun the process of checking things out, and you can proceed according to your doctor's discretion and the test results.
Hope this helps,
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