Background: Growing pains being episodic benign pains are often over diagnosed and under evaluated. Case Characteristics: A 4-year-old girl presented with complaints of frequent intermittent knee joint pain especially nocturnally. Serum profile studies were within normal limits. Ultrasound of both knee and hip joint was normal. MRI of right knee showed patellar osteitis with retropatellar serositis. Outcome: A short course of oral steroids resulted in symptomatic relief within 3 days where a treatment for 4 months with NSAIDs could not provide major relief.

Keywords: Growing pains; Retropatellar serositis; Kohler’s disease; Naish and Apley diagnostic criteria.