Is it normal to hear knee clicking in a 6-year-old?

Question

Hi doctor,

My son is 6-years-old. His height is 1.5 feet, and his weight is 44 lbs. He has been thin for the last two years despite eating well. Over the previous six months, he has had clicking sounds from his knees during any knee movement. I have seen such knee clicks in people above 60 years of age. He keeps many things in his mouth and puts his hand most of the time in his mouth.

He was sick two years ago and started becoming thin after that. We checked his CBC, and everything looks normal. His TSH is slightly high. His vitamin D level was slightly low, and we are giving him supplements. Now, vitamin D has come back to normal two months ago. He drinks one cup of milk on average every day. We still hear the clicking sound, and I sense his knee strength is low as we see he cannot balance well when he jumps. He is not telling of any pain and also no swelling.

My questions are as follows;

1) Could there be some bacterial or parasite infection causing his metabolism high?

2) Does knee clicking sound normal in some kids?

3) Could there be some infection impacting his joints and metabolism with no other symptoms like a fever?

4) Is there any component in CBC that indicates long-term hidden bacterial, viral, or parasite infection?

5) Does he require any additional tests?

Kindly help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your questions in detail.

The first thing that you are concerned about is the clicking sound at the knee joint. The clicking sound usually comes from the air bubbles in the joint. The clicking sound is usually normal, but if there is pain during joint movement, swelling at the joint, or restriction of movement, there are chances of some pathology like juvenile rheumatic arthritis.

Sometimes clicking sounds may result from a knee injury, but it is usually painful, and there will be a restriction in movement. Since calcium and vitamin D levels are normal, it is not related to calcium or vitamin D deficiency. In my opinion, if the clicking sound is not associated with pain, swelling, or restriction of movement, then you should not be worried. If pain, swelling, or restriction of movement is present or any history of a knee injury, then orthopedic consultation should be taken.

Your other concerns are;

1) High metabolism does not seem to be related to any infection.

2) No additional tests are required at this time.

An opinion of an orthopedic doctor should be taken so that we may not miss any important findings.

I hope this will help you.

I wish your child good health.

Take care.