Q: My son is five years old. From the past six months he is complaining of pain in his knees, feet and joints. The pain is not regular, but occurs once in a fortnight. What is the cause and treatment for this?

A:Your son should be evaluated by a paediatric rheumatologist to ensure that there is no arthritis, though the history given is atypical. In children with arthritis the joint pain is more in the mornings and the child has early morning stiffness, and gets better as the day goes on. In children with benign joint hypermobility, the pain is more in the evenings and there is no early morning stiffness. On examination, children with arthritis have joint swellings and children with hypermobility have joints that are very supple and typically have no swelling. The latter is common and is usually of no significance.