Question of the Month – October 2025
An 8-year-old child is seen for intermittent thigh pain that started seven months ago. She has difficulty sleeping but can fall back to sleep after her mother rubs her legs. She takes acetaminophen as needed. There is no history of trauma or recent illness. She has no change in her daily activities. On physical examination, she is afebrile. She has full range of motion of her lower extremities without joint tenderness. Her mother was recently diagnosed with an autoimmune disease and is concerned about the child’s pain.
Of the following, the best next step in this child’s management is to:
A. Order ANA testing
B. Provide reassurance
C. Recommend lower extremity radiographs
D. Refer to Rheumatology