An Approach to Joint Pain in Paediatric Patients: A Comprehensive Review

Joint pain in paediatric patients is a common but diagnostically challenging issue, with causes ranging from benign self-limiting conditions to serious diseases that may result in long-term disability. This review addresses a structured diagnostic approach to joint pain in children, covering infectious, inflammatory, traumatic, and neoplastic causes. Key diagnoses include septic arthritis, juvenile idiopathic arthritis (JIA), Lyme arthritis, and malignancies such as leukaemia and osteosarcoma. A detailed history and physical examination are essential for identifying underlying conditions, distinguishing benign causes from emergencies. Infectious causes require urgent consideration, especially septic arthritis, which risks rapid joint destruction. Inflammatory conditions like JIA are common chronic arthritides in children and need timely referral for rheumatologic assessment. Malignancies and traumatic causes also warrant careful attention to avoid delayed diagnosis. Laboratory investigations—including complete blood counts, inflammatory markers (ESR and CRP), and autoantibodies (ANA and RF)—help support diagnoses. Imaging studies, particularly radiography, ultrasound, and MRI, are pivotal for assessing trauma, inflammation, and marrow involvement. Targeted approaches for specific conditions, such as joint aspiration in septic arthritis and serological testing for Lyme arthritis, are discussed. Advances in biomarkers, imaging, and biologic therapies—especially TNF inhibitors and interleukin blockers—are highlighted as emerging tools in diagnosing and managing paediatric joint pain, offering promising avenues for early diagnosis and personalised care.