Acute pain in extremities, the back, or the belly is caused by vascular occlusion in the blood vessels of the bone or gut.

Children with unexplained (bone) pain should be screened for sickle cell disease.

Sickle cell disease manifests at about the age of 6 months, when the fetal hemoglobin is almost completely replaced by hemoglobin S, commonly in the In the first 4 years of life.

Still in a small group of individuals sickle cell disease will manifest in their teens.

Heijboer et al. Ned Tijdschr Geneeskd. 2007;151:2498-501