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Updated: Aug 11, 2026
A Novel Application of Musculoskeletal Ultrasound Imaging
Published on: September 17, 2013
Decreased bone speed of sound in children with growing pains measured by quantitative ultrasound
Orit Friedland1, Philip J Hashkes, Lutfi Jaber
1Department of Pediatrics, Pediatric Rheumatology Service, Meir Hospital, Kfar-Saba, Tel-Aviv University, Tel Aviv, Israel.
Insights
Growing pains (GP) in children are linked to reduced bone speed of sound (SOS), particularly in the tibia. This suggests growing pains may stem from a local overuse syndrome in pediatric musculoskeletal pain.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Health
- Quantitative Ultrasound
Background:
- Growing pains (GP) are a common cause of recurring musculoskeletal pain in children.
- The underlying etiology of GP remains incompletely understood.
- A hypothesis suggests GP may represent a local overuse syndrome.
Purpose of the Study:
- To investigate the association between growing pains and bone health.
- To determine if children with growing pains exhibit decreased bone speed of sound (SOS).
- To explore the potential of quantitative ultrasound (US) in assessing bone characteristics in children with GP.
Main Methods:
- A study involving 39 children diagnosed with growing pains.
- Bone SOS measurements were performed using quantitative ultrasound (US) on mid-tibial and radius bones.
- Statistical comparison of bone SOS in patients versus healthy controls using unpaired Student t-tests.
Main Results:
- Significantly reduced tibial bone SOS was observed in children with GP compared to controls (p = 0.004 for boys, p < 0.001 for girls).
- Radius bone SOS was significantly lower in girls with GP (p = 0.006).
- No significant correlation was found between bone SOS and most demographic/clinical factors, except ethnicity and BMI.
Conclusions:
- Children experiencing growing pains demonstrate significantly reduced bone speed of sound, especially in the tibia.
- These findings support the hypothesis that growing pains may be indicative of a local overuse syndrome.
- Quantitative ultrasound may serve as a valuable tool in understanding the pathophysiology of pediatric musculoskeletal pain.
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.
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