Wednesday, February 9, 2011

Osteochondrosis and joint pain in children

A review article in the February 1st issue of AFP summarizes a group of childhood skeletal disorders known collectively as osteochondrosis:

Osteochondrosis results from abnormal development, injury, or overuse of the growth plate and surrounding ossification centers. Overall, boys are more affected and symptoms generally appear between 10 and 14 years of age. It is thought that boys are more commonly affected because of their greater susceptibility to childhood trauma and overuse injuries. Patients usually present with pain and disability. Areas of the body most often affected include the hip, knee, foot, elbow, and back.

Although the majority of these disorders are self-limited and require only rest and pain control, all patients with possible diagnoses of Legg-Calve-Perthes disease (interruption of vascular supply to the femoral head) or Scheuermann disease (disturbance of the vertebral end plates causing kyphosis, or humpback deformity) should be referred for orthopedic evaluation. In addition, medial eipcondyle apophysitis (better known as "Little League elbow") can be prevented by limiting young athletes' numbers of pitches, curveballs, and sliders.

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