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Children knee pain

Eric J Rebich, Stephanie S Lee, John A Schlechter
BACKGROUND: Children with slipped capital femoral epiphysis (SCFE) are often seen by an array of medical professionals prior to diagnosis. Patients with mild slips, slips with knee pain, or bilateral slips can occasionally present a diagnostic challenge that increases the risk of a delay in diagnosis and associated complications. OBJECTIVES: This study introduces a new radiographic parameter, which we refer to as the S-sign, and analyzes its diagnostic utility on a frog-leg lateral radiograph...
March 14, 2018: Journal of Emergency Medicine
Steven Slotkin, Andrew Thome, Cassandra Ricketts, Andrew Georgiadis, Aristides Cruz, Mark Seeley
Anterior knee pain (AKP) is a common presenting complaint for pediatricians and orthopaedic surgeons and is often seen in young athletes. AKP is multifactorial and has a broad differential diagnosis. The growth changes, biomechanics, and anatomy around the knee add to the complexity of diagnosis and treatment of AKP. Common causes of AKP include Osgood-Schlatter's disease, patellar tendinitis, and patellofemoral instability. In the diagnosis of AKP, it is important to rule out serious and morbid causes of pain, including infection and tumor...
February 28, 2018: Journal of Knee Surgery
Yasaman Safarpour, Bahman Jabbari
This review evaluates the existing level of evidence for efficacy of BoNTs in different pain syndromes using the recommended efficacy criteria from the Assessment and Therapeutic Subcommittee of the American Academy of Neurology. There is a level A evidence (effective) for BoNT therapy in post-herpetic neuralgia, trigeminal neuralgia, and posttraumatic neuralgia. There is a level B evidence (probably effective) for diabetic neuropathy, plantar fasciitis, piriformis syndrome, pain associated with total knee arthroplasty, male pelvic pain syndrome, chronic low back pain, male pelvic pain, and neuropathic pain secondary to traumatic spinal cord injury...
January 31, 2018: Toxicon: Official Journal of the International Society on Toxinology
Giorgio Veneziano, David P Martin, Ralph Beltran, NʼDiris Barry, Dmitry Tumin, Candice Burrier, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND AND OBJECTIVES: Perineural dexamethasone has been demonstrated to extend postsurgical analgesia after peripheral nerve blockade in adults. The mechanism of action of dexamethasone as a regional anesthetic adjuvant is unclear as intravenous dexamethasone has been shown to have similar analgesic efficacy as perineural dexamethasone. The efficacy of perineural dexamethasone has not been previously explored in the pediatric population. METHODS: After obtaining informed consent, children (aged 10-18 years) presenting for arthroscopic knee surgery with a femoral nerve block were randomized to 1 of 3 groups: ropivacaine 0...
January 26, 2018: Regional Anesthesia and Pain Medicine
Robert J Tamai, Brian T Sullivan, Rushyuan J Lee
BACKGROUND: Peripheral nerve blocks (PNBs) provide excellent pain control and reduce the need for systemic analgesics in orthopaedic surgery. PNBs rarely cause complications; however, a few studies of adults have reported neurological complications during the early postoperative period. We investigated complications associated with the use of PNBs during pediatric knee surgery. METHODS: We reviewed the medical records of all 121 children (aged ≤18 y) who underwent knee surgery by 1 orthopaedic surgeon between October 2014 and September 2016...
March 2018: Journal of Pediatric Orthopedics
Jonathan D Haskel, Tyler J Uppstrom, David M Dare, Scott A Rodeo, Daniel W Green
PURPOSE: The purpose of this study was to examine the long-term clinical outcomes of arthroscopic partial meniscectomy for the treatment of discoid lateral meniscus in children. METHODS: A previous study identified 34 consecutive patients that underwent arthroscopic meniscal saucerization by one of the two surgeons between 1997 and 2002. Patients were asked to complete several outcomes questionnaires and were given the opportunity to receive a knee exam performed by their treating surgeon...
January 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
M M Elzohairy
BACKGROUND: Pyomyositis PM is defined as a primary pyogenic infection of the striated skeletal muscle; although it has many dystrophic musculoskeletal complications, it is always misdiagnosed by many orthopedic surgeons. HYPOTHESIS: PM is rare in temperate climates and usually considered to be a tropical disease, until recent times, after globalization, it is possible to occur in the subtropical climate as in our country. MATERIAL AND METHODS: In the present series, the results of 15 children patients with primary pyomyositis have been reviewed...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Anders Elneff Graversen, Niels Wisbech Pedersen, Roland Knudsen
Slipped capital femoral epiphysis (SCFE) is a serious orthopaedic hip disease in the adolescent population. It has a prevalence of 10.8 per 100.000 children and usually occurs in children 9-16 years of age. Despite focus on delay of the diagnosis, no improvements have been made. An adolescent complaining of stress-related pain in the hip, groin, thigh or knee should be suspected of having SCFE, until an X-ray has excluded this diagnosis. Delayed diagnosis may have serious consequences in terms of further displacement of the femoral head and risk of increased avascular necrosis...
December 11, 2017: Ugeskrift for Laeger
Scott C E Brandon, Darryl G Thelen, Colin R Smith, Tom F Novacheck, Michael H Schwartz, Rachel L Lenhart
BACKGROUND: Elevated tibiofemoral and patellofemoral loading in children who exhibit crouch gait may contribute to skeletal deformities, pain, and cessation of walking ability. Surgical procedures used to treat crouch frequently correct knee extensor insufficiency by advancing the patella. However, there is little quantitative understanding of how the magnitudes of crouch and patellofemoral correction affect cartilage loading in gait. METHODS: We used a computational musculoskeletal model to simulate the gait of twenty typically developing children and fifteen cerebral palsy patients who exhibited mild, moderate, and severe crouch...
December 5, 2017: Gait & Posture
Shogo Hashimoto, Kazutaka Kikuta, Tetsuya Sekita, Robert Nakayama, Shinichiro Takayama, Aya Sasaki, Kaori Kameyama, Masaya Nakamura, Morio Matsumoto, Hideo Morioka
BACKGROUND: Lipoblastomas are rare benign tumors that arise from embryonic white fat and almost always occur in babies and children. Here, we report a case of a giant popliteal lipoblastoma in a 23-month-old Japanese girl that was successfully treated via complete resection. CASE PRESENTATION: Our patient was a 23-month-old Japanese girl. At 6 months of age, she presented at a nearby hospital with a mass on the popliteal side of her lower right leg. She had no symptoms and was diagnosed as having a benign adipose tumor via magnetic resonance imaging...
December 5, 2017: Journal of Medical Case Reports
A Agarwal, N Gupta, M Mishra, N Agrawal, D Kumar
Clinical series of primary epiphyseal and metaepiphyseal tubercular osteomyelitis are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 8 such cases in children. MATERIAL AND METHODS: The patients were evaluated for pain, deformity, range of motion, limb length discrepancy (if any) and recurrence. Serial radiographs of the region were studied to see remineralization, obliteration of radiological lesions, status of physis and remodeling of the growth plate...
December 2016: Acta Orthopaedica Belgica
Signe Fuglkjær, Jan Hartvigsen, Niels Wedderkopp, Eleanor Boyle, Eva Jespersen, Tina Junge, Lisbeth Runge Larsen, Lise Hestbæk
BACKGROUND: Musculoskeletal pain is common in childhood and adolescence, and may be long-lasting and recurrent. Musculoskeletal problems tend to follow adolescents into adulthood, and therefore it is important to design better prevention strategies and early effective treatment. To this end, we need in-depth knowledge about the epidemiology of musculoskeletal extremity problems in this age group, and therefore, the aim of this study was to determine the prevalence, frequency and course of musculoskeletal pain in the upper and lower extremities in a cohort of Danish school children aged 8-14 years at baseline...
November 25, 2017: BMC Musculoskeletal Disorders
Francesc Malagelada, Ole Rahbek, Cyrus Sahirad, Manoj Ramachandran
Purpose: Recurrent patellar instability is a cause of knee dysfunction, limitation and pain for children. If nonoperative treatment fails to stabilise the patella, operative realignment and stabilisation have been advocated. Operative techniques in the paediatric population must preserve physeal growth while ensuring stability. We aimed to determine the outcome of children and adolescents who underwent a 4-in-1 patellar realignment (lateral release, medial reefing, Insall tube realignment and Roux-Goldthwaite patella ligament transfer)...
March 2018: Journal of Orthopaedics
Nawal El Houmami, Dimitri Ceroni, Karine Codjo Seignon, Jean-Christophe Pons, Cédric Lambert, Guillaume André Durand, Philippe Minodier, Léopold Lamah, Philippe Bidet, Jacques Schrenzel, Didier Raoult, Pierre-Edouard Fournier
Kingella kingae is an important cause of invasive infections in young children from Western countries. Although increasing reports indicate that this organism is the leading agent of bone and joint infections in early childhood, data on K. kingae infections from resource-limited settings are scarce, and none has yet been reported in Africa. We herein report the diagnostic and epidemiological investigations of the first case of K. kingae arthritis identified in a child from sub-Saharan Africa. A 5-year-old Cameroonian boy presented with a sudden painful limp which appeared in the course of a mild rhinopharyngitis...
2017: Frontiers in Pediatrics
Zhi Gang Lan, Seidu A Richard, Jiagang Liu, Chao You
Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44-year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee...
August 29, 2017: Neurology International
Mininder S Kocher, Catherine A Logan, Dennis E Kramer
Discoid meniscus is a congenital variant of the knee joint that typically involves abnormal morphology and potential instability of the lateral meniscus. Some discoid menisci have abnormal peripheral attachments and are unstable. Discoid menisci are prone to tearing secondary to increased thickness, poor tissue quality, and instability. Patients may or may not be symptomatic. Torn or unstable discoid menisci cause mechanical symptoms, pain, and swelling. Symptomatic patients in whom nonsurgical management fails most frequently are treated with arthroscopic surgery...
November 2017: Journal of the American Academy of Orthopaedic Surgeons
Signe Fuglkjær, Kristina Boe Dissing, Lise Hestbæk
BACKGROUND: It is difficult to gain an overview of musculoskeletal extremity complaints in childhood although this is essential to develop evidence-based prevention and treatment strategies. The objectives of this systematic review were therefore to describe the prevalence and incidence of musculoskeletal extremity complaints in children and adolescents in both general and clinical populations in relation to age, anatomical site and mode of onset. METHODS: MEDLINE and EMBASE were electronically searched; risk of bias was assessed; and data extraction was individually performed by two authors...
October 18, 2017: BMC Musculoskeletal Disorders
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Vivek Tiwari, Venkatesan Sampath Kumar, Rishi R Poudel, Ashok Kumar, Shah Alam Khan
Osteochondromas are the most common bone tumours. Although these tumors are relatively common in the long bones of children, the varied clinical and radiographic presentation of such neoplasms around the knee joint can cause diagnostic delays, especially when not associated with a palpable swelling. Proximal tibial osteochondromas can sometimes unusually present as spurs/ rose thorns leading to pes anserinus bursitis and vague knee pain. We describe the clinico-radiographic features of such proximal tibial metaphyseal osteochondromas giving rise to pes anserinus bursitis in three children, including bilaterally symmetrical osteochondroma in one of the cases, who were treated conservatively with good outcomes...
July 5, 2017: Curēus
Koray Şahin, Serkan Bayram, Ahmet Salduz
Ewing's sarcoma (ES) represents the second most common primary malignant tumor of bone of children and occurs rarely in the bones of the foot. Dissemination to regional lymph nodes and skip metastases to adjacent bones are thought to be uncommon. We report a case of a 19-year-old female with the diagnosis of ES of the right calcaneus. Six months earlier, she had presented to the hospital with a history of ankle sprain and was treated with analgesics and ice application. Despite the treatment, the pain over the ankle persisted, her foot swelled progressively, and a mass evolved on the lateral side of the foot...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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