Simon is a sixteen-year-old adolescent admitted to the paediatric ward with unexplained knee and hip pain. He has been unable to attend school because of his difficulty moving around the school. Reaching classes held in upstairs rooms has been impossible for him. In addition, he has often felt too tired to manage a full day of study Shooting pains and aches in his legs have left him feeling miserable and hopeless. While undergoing extensive medical investigations, he is required to attend physiotherapy sessions twice a day to try to bring him some pain relief and to ensure he doesn't develop secondary effects of immobility. During physiotherapy, he complains loudly about the physiotherapist's attempts to mobilise his joints, grimacing and crying to the extent that he distresses other children in the gym. On the ward, when people ask him how he is, he complains of extreme pain, but his descriptions are inconsistent with his otherwise relaxed behaviour and enjoyment of activities. On

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