A child’s knee hurts: what to do?

“Safe” causes of knee pain in a child

In early childhood and adolescence, children experience “growing pains.” Tissues grow and develop unevenly, which causes discomfort and moderate discomfort. This phenomenon is not characterized by sharp, acute pain.

In teenagers, knee pain may occur due to hormonal changes. The restructuring of the body is accompanied by a temporary thinning of the cartilage. The situation is aggravated by excessive physical activity or, conversely, physical inactivity and poor diet. In this case, the pain is also intermittent, aching, but not acute. An orthopedist can confirm or refute the safety of a symptom.

Sharp knee pain in a child always requires medical attention

Chondromalacia in children and adolescents involved in sports: a note for parents.

Unfortunately, chondromalacia, which has been written about more than once on this site, is a problem faced not only by professional athletes, but even not only by people leading a very active lifestyle. A disease such as chondromalacia can lie in wait for us even in ordinary everyday life, and affect those whose pace is very measured and not at all extreme. Experts debate whether low physical activity is a way to protect yourself from chondromalacia, and come to the conclusion that neither excessive exercise nor rest alone are a guarantee that chondromalacia will not affect you. It all depends on the condition of the knee and how the loads are dosed and applied.

Let's say everything is clear with professional sports. Chondromalacia, also known as “runner's knee,” is most common among runners. Very often, people who are professional rowers receive a similar diagnosis. There are other sports whose adherents are familiar with chondromalacia firsthand. In everyday life, young women encounter the disease (this happens for physiological reasons: due to the special structure of the female joint, it endures a greater load), and especially pregnant women, when their weight can increase by 20% of their normal weight or more. In general, doctors have come to the conclusion that we can talk about chondromalacia of varying degrees (perhaps incipient and not pronounced) in almost all people. But there is a special category of patients whose illness is always discussed separately. These are children and teenagers. And if we are talking about chondromalacia of the patella, then first of all these are children who play various sports. They are the ones at risk, because their growing joints endure stress, while parents usually rely entirely on coaching experience and don’t even think about whether their child may have incipient knee problems. There are a lot of sports children in our country; almost every second one goes to the sports section. Lack of warm-up, ill-considered loads, and inattention of children can lead to various injuries, noticeable or latent, which will certainly make themselves felt later if they are not identified in time.

Diagnosis is complicated by the fact that children, as a rule, cannot clearly tell what and how it hurts, and often do not pay attention to it at all. Therefore, parents, seeing their child’s interest in any sport, must definitely find information about how the “entrance” to this sport should be organized, how training should be structured. And after that, you should attend a couple of classes to see if the trainer does the same. If they don’t pay attention to the basic sports rules in the section, then you should look for another place: health is always more important than such amenities as the proximity of the section to home, etc. What do parents need to know? The child's musculoskeletal system is in constant development. This is a risk factor for many injuries. And in combination with sports activities, it forces parents to be especially attentive. Not only do children experience all the types of injuries that occur in adult athletes, but they also experience injuries that are not typical for adults. Diagnosis of childhood injuries is also difficult due to the presence of epiphyseal growth zones. It is impossible to identify injuries that are characteristic of a certain age: here the matter depends precisely on the maturity of the musculoskeletal system. Chondromalacia of the patella requires mandatory consultation with a traumatologist. Usually this is not delayed, since this disease is accompanied by pain in the anterior surface of the anterior joint.

And one more important aspect: in the presence of an anomaly in the development of the musculoskeletal system, the risk of injury increases many times over. Unfortunately, in modern Russia there are a lot of children who are underexamined from this point of view, and whose participation in sports can be harmful. Show more attention to your children, then neither fermatron, nor interventions in the joints, nor long trips to the doctors will be needed. The first line of protection for children from diseases is, after all, parents, who should collect data for doctors if their consultations are still needed.

How to diagnose a child with knee pain

A referral for diagnostics is given by an orthopedist, neurologist or rheumatologist. When the first symptoms appear, it is better to contact a pediatrician, who will refer you to the right specialist. The doctor will conduct an examination and, after collecting anamnesis, prescribe one or more examinations:

radiograph;
MRI;
CT;
electrocardiogram;
laboratory blood tests, etc.

Diagnostics will allow you to find out the exact cause of pain in the knee, whether it is gonarthrosis with deformation of the articular joint, narrowing of blood vessels, compression of nerves or a banal bruise.

How to treat a child’s complaints of knee pain? Opinion of a practicing orthopedic traumatologist:

What to do

The most important thing for parents when detecting knee pain in their child is to rule out a serious illness, so you should not wait until the pain goes away on its own, but show your child to specialists as early as possible. Even if the injury itself is mild, it must be treated, since the consequences for a growing body can be unpredictable. In the following cases, you should consult a doctor immediately:

The injury prevents the child from walking.
The pain is accompanied by an increase in temperature.

Features of the treatment of knee pain in children

In childhood and adolescence, treatment of osteoarthritis and other pathologies is conservative. This includes medications, physical therapy, exercise therapy, supportive interventions such as massage or acupuncture, and dietary and physical activity changes. If necessary, adolescents are prescribed intra-articular injections of a liquid endoprosthesis, which is distributed inside the joint and stops the friction of thinned cartilage due to osteoarthritis.

In extremely rare cases, the only way to get rid of knee pain is through surgery. The following operations are used:

if the bones or joint are severely deformed;
if there is a cyst or abscess in the joint;
in other complex cases that are not amenable to conservative treatment.

Complex therapy under the supervision of a good specialist helps to quickly get rid of knee pain, relieve inflammation and swelling, if any, and also improve blood circulation in the legs. The orthopedist’s task is to help the child’s body develop normally, despite disruptions, strengthen local immunity and restore the natural structure of the joint. Modern techniques allow us to solve the most complex health problems. The main condition is to apply as early as possible!

Features of treatment

The treatment plan is most often conservative. Surgery is rarely required if a child has pain behind the knee:

with severe deformation of bones or joints;
in the presence of an abscess or articular cyst;
in some other difficult cases.

Therapeutic treatment is complex and includes:

taking medications;
exercise therapy;
physiotherapy;
auxiliary methods (massage, acupuncture, etc.);
normalization of diet and rest.

An integrated approach allows you to eliminate pain, swelling and inflammation, as well as provide the body with necessary substances, improve blood circulation and tissue nutrition, strengthen local immunity and restore the normal structure of the joint. In all clinics of the Hello! There is modern equipment necessary for early diagnosis of joint pathologies. Experienced and attentive medical staff provide small patients with the most comfortable conditions during treatment, and the use of classical and latest techniques allows for a quick full recovery.

Treatment

Osgood-Schlatter disease usually resolves on its own, and symptoms disappear after bone growth has completed. If the symptoms are severe, then treatment includes medication, physiotherapy, and exercise therapy.

Drug treatment involves prescribing pain relievers such as acetaminophen (Tylenol, etc.) or ibuprofen. Physiotherapy can reduce inflammation and relieve swelling and pain.

Exercise therapy is necessary to select exercises that stretch the quadriceps muscle and hamstrings, which reduces the load on the area where the patellar tendon attaches to the tibia. Hip strengthening exercises also help stabilize the knee joint.

Joint pain in a child: what diseases can be suspected?

Does your child complain of pain in their legs or arms? Do you suspect that the problem most likely lies in the joints? What can these symptoms indicate, what diseases can be suspected, and what should be done in such cases? Let's talk about this with KinderKlinik pediatrician, specialist of the highest category Tatyana Kuzmenko.

Tatyana Vladimirovna, what to do if a child complains to his mother: “My legs/arms hurt”?

The first thing you need to understand is whether this is an injury? To begin with, ask your child if he fell or hit himself the day before; at the same time, ask the teacher, grandmother, teacher, nanny - was there any injury? Observe the baby - how he gets out of bed, how he sits, walks, is he limping, examine the joints carefully - are they symmetrical, is there any swelling, redness, increased temperature both in the joint area (to the touch) and body temperature? are there any signs of bruise? Also pay attention to whether the baby is active or lethargic.

If the answer to the question about injury is positive, you must immediately consult an orthopedic traumatologist and conduct an examination to rule out a crack or fracture of the bone, ligament rupture, or bruise.

There are often situations when turning to an orthopedist helps to identify other diseases of the musculoskeletal system: flat feet, various types of deformities of the legs, Schlater's disease, hip dysplasia not diagnosed at an early age, etc.

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Are there other causes of joint pain in a child?

Arthritis

A large group of diseases is arthritis and its varieties. Remember, this is not only a problem for grandparents; their little grandchildren (most often preschoolers) also have arthritis. The disease often goes away quickly and has every chance of not reoccurring, provided that you consult a pediatrician, pediatric rheumatologist, or orthopedist in time.

This is an inflammation of the joint, first of all, of its synovial membrane, in other words, the film lining the entire joint cavity from the inside. Arthritis usually begins with damage to one joint, although polyarthritis (affecting several joints) also occurs. As a rule, pathology is discovered after an infection. It is no wonder that parents do not always associate the baby’s new lameness with ARVI 3 weeks ago, so remember this and do not dismiss the idea that a long-standing mild runny nose or tracheitis has caused inflammation of the joints.

The culprits of inflammation can be pathogenic bacteria that enter the joint cavity from any focus in the child’s body, through the blood, or during injuries. The most common agents are streptococcus and staphylococcus. If your baby often suffers from tonsillitis, bronchitis, laryngitis, tracheitis, he is at risk. This type of arthritis is dangerous because it can cause the accumulation of pus directly in the joint capsule, causing its deformation (a high degree of disability).

Joint inflammation can also be caused by various viruses: influenza, rubella, hepatitis, mumps and some others. Symptoms depend on the type of virus, inflammation can be transient (temporary), occurring during the period of the underlying disease, swelling of the joints and intermittent pain are noted (in some joints, inflammation can quickly subside (even without treatment), but immediately begin in others). But the mumps virus causes harm only 1-3 weeks after infection, affecting only large joints. Most viral arthritis usually goes away within 7-14 days with timely and proper treatment.

Another group of arthritis is arthritis that occurs when a child develops a systemic connective tissue disease (juvenile rheumatoid arthritis, rheumatism, systemic lupus erythematosus, dermatomyositis, periarteritis nodosa, etc.). These are autoimmune diseases (as, indeed, are most transient inflammations of the joints). At first, stiffness and pain are annoying in the mornings, then during the day. As a rule, joint damage in these diseases requires a thorough examination, complex and long-term treatment under the guidance of highly qualified specialists (pediatricians, pediatric cardio-rheumatologists).

It should also be noted that post-vaccination arthritis - a relatively rare complication, more often with vaccination against rubella, less often with mumps, whooping cough and chickenpox. Signs of arthritis appear 1-3 weeks after the injection, but with timely consultation with a doctor and timely medical care, they quickly and completely disappear.

A separate group of diseases that affect joints is purulent osteomyelitis (bone inflammation), intestinal and genitourinary infections, tuberculosis, meningitis, neoplasms, and blood diseases.

Growing pains

But it may also happen that the doctor will dispel all your doubts, and your fears will not be confirmed - this will happen when the diagnosis sounds like this: growing pains, one of the most common causes of joint pain in children. Growing pains occur during periods of the child's most active growth - from 4 to 5-7 years, at 9-10 years, at 13-15 years. At this time, bones and ligaments grow unevenly, not keeping up with each other; the ligaments put pressure on the joint capsule, causing the baby discomfort in the hips, calves, and feet. It is typical that the pain occurs during rest, more often in the evening or at night, while there is no increase in body temperature in the joint area, there is no swelling or redness of the joint, the child is active, and during the day he does not even remember that his leg hurt in the evening or at night .

So, if your baby complains of joint pain, in any case you need to consult a pediatrician , orthopedist , or pediatric cardio-rheumatologist . Perhaps the doctor will dispel your doubts, and your baby will have growing pains, but in the case of a serious illness, only a doctor will be able to prescribe a comprehensive examination (general blood and urine tests, immunological studies, if necessary, an electrocardiogram and ultrasound of the heart, ultrasound of the joints and x-rays of the affected area etc.), and will also create an individual treatment plan for your baby.

Be attentive to your child and be healthy!