earache

Earache is not exactly the same thing as an ear infection; in fact, it has its own diagnosis code for a painful ear with no infection found (I am sure you find that just as interesting as I do). An ear that is aching and painful (or in the preverbal child seems to be) could represent any of the following:

The ear that is actually infected
- in the middle ear cavity - otitis media
- in the external ear canal - otitis externa or more commonly, swimmers ear
the ear that appears normal is the most frustrating case, but this happens a lot: the pressure equalizing eustachian tube inside the head is blocked, causing a pressure differential (actually a vacuum or suction) behind the eardrum. Stretching the eardrum with gas pressure hurts just as badly as stretching it with the pressure of pus.
earwax just doesn't cause ear pain

Other causes of ear pain or pain felt in the vicinity of the ear:

teething of course likewise - no pain - maybe some ear rubbing (but who among us can remember)
pain referred to the ear canal from the oral cavity - a toothache or gum problem
pain that arises from the temporomandibular joint (TMJ) and is felt in the ear canal area
scratch of the ear canal or trauma from an object inserted in the ear
foreign objects like beads, stones, and wads of paper are commonly found incidentally in the ear canals of young children, but I cannot recall a child complaining of the foreign body being there; they are unaware of it

So if you take Junior to the doctor for his earache, and nothing is found - well, it happens. Neither Junior nor your doctor is pulling your leg! And you might get a surprise.

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