Table 1. Potential attribution of behaviors to different underlying causes of pain.

Behavior	Possible causes	Diagnostic test or empirical treatment
Rolling and throwing self on the ground, “like a seizure”	Colic	Upper abdominal ultrasoundInternal medical diagnostic work-up
Striking self in the face, spitting	Toothache, sinusitis, herpes zoster	Medical and dental examination
Agitation, self-inflicted injury	Pruritic skin disease	Inspection of the unclothed patient, physical examination of the entire body
Rubbing the ear	Otitis, tubal ventilation disturbance	Otoscopy, nose drops against swelling
Refusal of food	Neck pain, toothachepharyngitis, ulcer	Oral inspectionGastroscopy as indicated
Manipulation in the genital area	Urinary tract infection or other infection	Urinalysis; inspection and examination of the genital region
Regurgitation, rumination	Reflux, achalasia, gastrointestinal disease	Physical examination H2-blockers, gastroscopy as indicated
Moor agitation, aggression against others or self, shouting	Urinary retention, fractures, other acute and severe pain (e.g., testicular torsion!)	Whole-body physical examination including digital rectal examination, CT/MRI under general anesthesia
Shouting, antalgic posture	Fracture, other injury	Physical examination, x-rays, CT

CT, computed tomography; MRI, magnetic resonance imaging