<s>[INST] Hi, my 5 1/2 yr old son has been complaining for the last 2 months that his rt leg hurts. He d wake up in the middle of the night crying. Thought it might just be growing pains . But last few weeks it has gotten progressively worse. I have to give him ibupropron 2-3 times/day. Tylenol just doesn t work. His pediatrician did x-ray and blood work, nothing looked abnormal. Then, 2 1/2 wks ago, he got this bad rash all over his legs and eventually on his elbows. Almost looked like blisters, big & puffy. Took him to dermatologist, thought it might be a viral infection. This rash is almost cleared up with steroids (both oral & cream). Then took him in to a pediatric orthopedic who also did x-rays, still nothing showed up. He does have an appt for a bone scan next week. But, now he has developed another rash all over his body. This rash looks different than the one before, little, tiny pumps (what I normally see rashes look like, compared to the other rash he had). Now today, he has been complaining his stomach hurts. He s not running a fever, just doesn t feel good. The pediatric orthopedic thought possibly these 2 symptoms were related (he doesn t know he now has another rash or stomach ache). Should I be overly concerned right now? Or is o.k. to wait till his appt next week? [/INST] Hi.... all your kids symptoms fit into a common problem which is most probably vasculitis. This could also be a connective tissue disorder like Juvenile rheumatoid arthritis or SHE.  I suggest that you work up the kid in the line of Juvenile rheumatoid arthritis as the pain abdomen along with rash and joint pains are definitely fitting into this diagnosis. This requires further evaluation and long-term follow-up.  I suggest you consult a pediatric rheumatologist. Regards -  </s>