A 5-year-old boy presents with chronic nocturnal limb pain. What is the most appropriate management for this condition?

The management of chronic nocturnal limb pain in a 5-year-old boy is most appropriately approached with the option of no further workup. This type of pain is commonly associated with a condition known as "growing pains," which is prevalent in children and typically reflects normal development.

Growing pains are usually characterized by intermittent pain in the legs, primarily occurring at night and often resolving by morning. They do not usually require further diagnostic investigation unless there are concerning features that suggest an underlying pathology, such as significant swelling, limping, or persistent symptoms through the day. In this case, since the child simply presents with chronic nocturnal limb pain, it is likely benign and reassured without the need for additional tests or interventions.

The other options—physical therapy, blood tests, and X-ray imaging—do not conform to the appropriate management pathway for isolated nocturnal limb pain in an otherwise healthy child without alarming symptoms. While these might be warranted in cases with additional clinical concerns, they are not necessary for typical growing pains, making the choice for no further workup the most suitable management.