Pediatric Musculoskeletal Conditions

According to the American Association of Orthopedics, musculoskeletal conditions account for over 500,000 hospital visits annually for individuals under the age of 21. With age not being a consideration, there are approximately 1.7 billion cases of musculoskeletal conditions worldwide.

Such conditions range greatly in both type and severity levels and include conditions like dysplasia, deformities, tumors, degrees of arthritis, and even infections.

The musculoskeletal system differs greatly between children and adults. As such, a pediatric musculoskeletal condition differs pathologically, anatomically, physiologically, and even psychologically regarding pain and discomfort.

In what follows, we’ll be discussing some details about pediatric musculoskeletal conditions and mention about some specific types of these conditions and their management and treatment.

Characteristics of a Musculoskeletal Condition

It’s best to start with the description of a musculoskeletal condition. Whether an injury, inherent disease, birth defect, infection, or idiopathic disorder, a musculoskeletal condition is one that affects the muscles, bones, joints, tendons, and spine of the human body.

Musculoskeletal conditions often develop from childhood and can worsen as the aging process unfolds. The pain, discomfort, and symptomatology of any given musculoskeletal condition range from mild to severe, typically heightened in children who lack any reference point of pain tolerance.

With regards to treating musculoskeletal conditions, there are several options that include occupational therapy, prescription medication, physiotherapy, steroidal injections, and other alternative therapies.

Types of Musculoskeletal Conditions

Many times the different musculoskeletal conditions are benign conditions and don’t require any significant intervention. Yet, in some cases, musculoskeletal conditions have the potential to become life-threatening if not treated early and correctly.

If a child presents with any of the following symptoms, it’s important to seek immediate medical attention to assess the issue and determine if an underlying musculoskeletal condition might exist.

• Systematic Symptoms (fever, inflammation, unjustified weight fluctuations)
• Physiological Dysfunction
• Bone or Joint Pain in multiple locations

 

Other than sport-related injuries such as sprains and contusions, some of the most common musculoskeletal conditions in children are related to generalized back pain and joint pain.

The following discussion covers some specific musculoskeletal conditions that are seen in children. The first two are more systemic, and the next 2 conditions are more simple focused conditions.

Juvenile Ideopathic Arthritis

Although there are many types of arthritis, juvenile ideopathic arthritis is a type of arthritis that occurs in children, causing stiffness and swelling of the joints. The systemic nature of this condition leads to signs and symptoms of rash and fever. Most children with juvenile ideopathic arthritis will outgrow the condition, however some cases will last for several years.

Treatment options for juvenile ideopathic arthritis are likely to include prescription medications including corticosteroids and NSAIDs, physical therapy, and occupational therapy.

Arthritis Related To Inflammatory Bowel Disease

Children and adolescents can develop the condition of arthritis in conjunction with the condition of inflammatory bowel disease. The two most notable inflammatory bowel conditions are Crohn’s disease and Ulcerative Colitis. The typical manifestations of arthritis in the extremities is seen in this condition and treatment is guided towards management of the inflammation.

The most common treatments are NSAIDs, glucocorticoids, and other antirheumatic drugs, such as sulfasalazine. In many cases, the treatment of the underlying inflammatory bowel disease will be the most effective management of the concurrent joint arthritis.

Nursemaid’s Elbow

Nursemaid’s elbow is a common childhood injury that occurs when the head of the radius bone which is located at the elbow joint becomes dislodged from the joint. This occurs because the child is still in the growth stage, and it can be easy for this bone to pull away from the joint with certain activities, such as swinging a child leading to strain at the elbow joint.

Nursemaid’s elbow is quite a common pediatric injury due to the lack of strength and development in a young child, occurring in 1 in 4 children. Because of the nature of the injury, the bone can be simply reduced to its normal position by a medical professional.

Osgood–Schlatter disease

Osgood-Schlatter disease is a common condition in adolescent children. It is characterized by significant inflammation at the location of the insertion of the patellar tendon at the tibia. This location on the tibia is known as the tibial tuberosity. It happens in young athletes who do lots of jumping. The strain of the activity causes inflammation at the growth plate which runs in the same area as the tibial tuberosity. The cartilage at this region often can’t sustain this type of stress and will develop swelling and pain.

The treatment for this condition is rest and ice for swelling. The condition will usually resolve with time.

Other pediatric musculoskeletal conditions include but are not limited to scoliosis, developmental hip dysplasia, transient synovitis (the most common cause of pediatric hip pain), in toeing, and flat feet.

Final Thoughts

Because of the range of differences between pediatric and adult musculoskeletal conditions, it’s imperative to have a knowledgeable pediatrician who understands these differences and can diagnose these conditions successfully.

Pediatric musculoskeletal injuries have a generally positive outlook, yet it’s important to remember that certain conditions can be severe and must be managed promptly.