Please reply to the following discussion . Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates. CBY discussion: : a common cause of leg pain in childhood, are characterized by poorly localized pain at night, which frequently wakes the child from sleep; no objective signs of inflammation; and no daytime symptoms (Hay, et al., 2020). Growing pains (benign idiopathic paroxysmal nocturnal limb pains): underlying cause and pathogenesis are not known, but contributing factors may include1excessive physical activity (DynaMed, 2018). : Fibromyalgia is a chronic pain syndrome characterized by diffuse musculoskeletal pain, fatigue, sleep disturbance, and chronic headaches. Weather changes, lack of sleep, and stress exacerbate symptoms (Hay, et al., 2020). The exact mechanisms of fibromyalgia development are unknown, but impaired central pain processing involving altered neuroreceptor and neuropeptide physiology appears to be primary disease driver (DynaMed, 2018). : Restless legs syndrome (RLS) is a neurologic disorder characterized by the irresistible urge to move the legs, usually worsening at rest, relieved with movement, and occurring in the evening or at night.The pathogenesis generally unknown, but hypotheses include: hypodopaminergic hypothesis based on relief of symptoms with dopaminergic treatment exacerbation or unmasking of symptoms with dopamine antagonists circadian pat
tern of RLS symptoms mimics circadian pattern of dopa-responsive dystonia. RLS patients usually exhibit iron deficiency (< 50 ng/mL) in many (DynaMed, 2018). In the case of growing pains, there are no diagnostic tests as it is considered a benign condition. However, if symptoms such as fever, swelling, and pain that doesnΒt get better with massage, heat, and pain medicine persists., diagnostic studies such as x-ray would be warranted. Testing to consider to rule out underlying causes if presentation is atypical includes: Cartilaginous bones: The bones of children are more cartilaginous and flexible than those of adults, and for this reason, green stick fractures are common in children i.e: fracture of supracondylar rather than dislocation of elbow (The Royal Children's Hospital Melbourne, n.d). The NP noticed that: Most common fractures are of the elbow and femur. Depending on the age of the child, the growth plate may be open, which places the child at risk of injury to the growth plate and subsequent abnormal healing limitation to the future bone growth (Burns, et al.,2019). : References Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C. (2019). Burns' pediatric primary care (7th ed.). Saunders. ISBN:9780323581967. DynaMed (2018).Fibromyalgia. Retrieved from DynaMed (2018).Growing Pains. Retrieved from DynaMed (2018). Restless Legs Syndrome (RLS) . Retrieved from Gavin, M. (2021). Growing Pains. Retrieved from Hay, W., Levin, M., Deterding, R. Abzug, M. & Sondheimer, J. (2020). CURRENT diagnosis and treatment: Pediatrics (25th ed.). McGraw-ll. ISBN: 978-1260457827. The Royal Children's Hospital Melbourne Β (n.d). Retrieved from