The mother of a four year old girl brings her to the office with the chief complaint that for the past three nights the child has awaken from sleep with pains in her legs. It is most common from 3-5 years of age, but may be seen up to 9 years of age. There is a greater incidence in girls.
Symptoms usually are pains that occur at the end of the day or awaken the child from sleep.
Most often the pains are bilateral and usually localized to the thighs or calves and do not involve the joints. Rarely, there may be pains in an upper extremity. The symptoms do not interfere with activities during the daytime. The symptoms are intermittent with periods of days or weeks without any pain. Physical examination is normal without any evidence of trauma, joint swelling, erythema, decreased range of motion, limp, or tenderness.