Q: My 10.5 years old daughter has pain in her hands and legs. The doctors told us that it is growing pains due to iron and calcium and is not rheumatic in nature. Her ASO is around 400 and varies from 200 to 400 in different labs. Should we go for penicillin therapy?

A:Involvement of the small joints of the hands are usually not indicative of a rheumatic arthritis. The pattern here is of a flitting joint pain and swelling that resolves within six weeks. Your daughter should be examined carefully by a paediatric rheumatologist and should not be given blind penicillin therapy.