Joint pain in children: reasons and what to do

Joint pain in children: reasons and what to do

I. Normal development and growth pain

A. Anatomy and physiology of children’s joints:

1. Features of the structure: children’s joints, especially during periods of intensive growth, differ from adults. The cartilage fabric is more elastic, the ligaments are more loose, and the bones have not yet been completely ossified. These features make joints more vulnerable to injuries and inflammations, but also provide flexibility and adaptability to the growing body. The articular surfaces are covered with hyalin cartilage, which provides smooth sliding and cushioning. The synovial shell lining the joint capsule produces a synovial fluid that lubricates the joint and provides nutrition of cartilage.
2. The role of hormones: hormones play an important role in the development of the musculoskeletal system. The growth hormone (somatotropin) stimulates the growth of bones in length and an increase in muscle mass. Sex hormones (estrogens and testosterone) affect the ossification of cartilage tissue and the formation of secondary sexual characteristics. The imbalance of hormones can lead to disorders of growth and development, which can appear in the form of joint pain.
3. The influence of physical activity: moderate physical activity is necessary for the normal development of the bone muscular system. It helps to strengthen bones, muscle development and improve the blood supply to the joints. However, excessive physical activity, especially with the improper technique of performing exercises, can lead to overload of the joints and pain. It is important to observe the balance between physical activity and rest in order to avoid overwork and injuries.

B. Pain of growth:

1. Determination and prevalence: growth pain is benign pain in the legs, which usually occur in children aged 3 to 12 years. They are characterized by an intermittive character, that is, they arise periodically and are not related to injury or other disease. The prevalence of growth pain is about 25-40% in children of this age group.
2. Streetings of growth pain: a. Localization: pain is usually localized in the legs, most often in legs, hips or knees. They can be bilateral or one -sided, but rarely occur in the joints. B. Time of occurrence: pain usually occurs in the evening or at night, sometimes they wake the child. In the morning, the pain, as a rule, pass. C. Intensity: the intensity of pain can vary from slight discomfort to severe pain, which prevents the child from falling asleep. D. Other symptoms: growth pain is not accompanied by other symptoms such as fever, redness or swelling of the joints, limitation of mobility.
3. The reasons for the occurrence: the causes of growth pain have not been fully studied. There are several theories explaining their occurrence: a. Rapid growth of bones: during periods of intensive bone growth can grow faster than muscles and ligaments, which leads to stretching and discomfort. B. Acting muscles: active children involved in sports or spending a lot of time on their feet may experience overwork of muscles, which manifests itself in the form of pain in the legs. C. Hereditary predisposition: in children whose parents in childhood experienced growth pain, the probability of their occurrence above. D. Psychological factors: stress and anxiety can increase pain.
4. Diagnosis of growth pain: the diagnosis of growth pain is made on the basis of an anamnesis, physical examination and exclusion of other diseases that can cause joint pain. Usually, additional studies are not required, such as x -ray or blood tests.
5. Treatment of growth pain: Treatment of growth pain is aimed at alleviating the symptoms and includes: a. Massage: light massage of painful areas can help relax muscles and reduce pain. B. Stretching: stretching the muscles of the legs before bedtime can prevent pain. C. Thermal procedures: a warm bath or heating pad for painful areas can help relieve muscle voltage. D. Anesthetic drugs: In the case of severe pain, you can use painkillers, such as paracetamol or ibuprofen. E. Sedding means: in some cases, sedatives can be assigned to improve sleep.
6. Forecast: growth pain usually passes on their own by adolescence. They do not have a negative effect on the health of the child and do not require special treatment.

II. Joint injuries

A. Types of injuries:

1. Link stretching: ligament stretching is an injury in which there is a rupture or tearing of ligaments that support the joint. Stretchions occur with sudden movements, dislocations or shocks on the joint.
2. Dislocations: dislocation is an injury in which the articular surfaces relative to each other occurs. Dislocations usually occur with severe blows or falls on the joint.
3. Fractures of bones: Fractures of bones forming the joint can occur with severe blows or falls. Fractures can be open (with skin damage) or closed (without damage to the skin).
4. Damage to meniscus: menis is cartilage gaskets located inside the knee joint. Damage to meniscus occurs with sharp turns of the knee or squat with a load.
5. Cartilage damage: cartilage, covering the joint surfaces can be damaged by impacts, dislocations or repeating microtraumas.

B. Causes of injuries:

1. Sports injuries: children involved in sports are at increased risk of joint injuries. Most often there are stretching ligaments, dislocations and bone fractures.
2. Falls: falls are one of the most common causes of joint injuries in children, especially at an early age.
3. Transport incidents: traffic accidents can lead to serious joint injuries, including fractures and dislocations.
4. Accidents in everyday life: accidents in everyday life, such as falling from the stairs or strokes on furniture, can also lead to joint injuries.

C. Symptoms of injuries:

1. Pain: Pain is the main symptom of joint injury. The intensity of pain can vary depending on the severity of the injury.
2. Edema: edema in the joint area occurs due to hemorrhage and inflammation of tissues.
3. Hematoma: hematoma (bruise) appears in the area of ​​injury due to damage to blood vessels.
4. Limiting mobility: restriction of joint mobility occurs due to pain and edema.
5. Joint deformation: joint deformation can be observed with dislocations and bone fractures.
6. Crushing or click in the joint: crunch or click in the joint may indicate damage to ligaments or meniscus.

D. Diagnostics of injuries:

1. Anamnesis: The collection of an anamnesis allows you to find out the circumstances of the injury, the nature of the pain and other symptoms.
2. Physical examination: A physical examination allows you to assess the condition of the joint, identify swelling, hematoma, deformation and limitation of mobility.
3. X -ray: radiography is the main method of diagnosing bone fractures.
4. Magnetic resonance imaging (MRI): MRI allows you to visualize the soft tissues of the joint, such as ligaments, meniscus and cartilage.
5. Computed tomography (CT): CT can be used to diagnose complex bone fractures.
6. Arthroscopy: Arthroscopy is an invasive diagnostic method, in which a special tool (arthroscope) is introduced into the joint to inspect its inner surface.

E. Treatment of injuries:

1. First aid: a. Peace: ensure resting the damaged joint. B. Cold: attach the cold to the injury area for 15-20 minutes every 2-3 hours during the first 24-48 hours. C. Compression: impose an elastic bandage on the injury to reduce edema. D. Rise: Raise the damaged limb above the level of the heart to reduce edema.
2. Medication: a. Anesthetic drugs: painkillers, such as paracetamol or ibuprofen, can be used to relieve pain. B. Anti -inflammatory drugs: anti -inflammatory drugs, such as Ibuprofen or Diclofenac, can be used to reduce inflammation.
3. Immobilization: a. Gypsum dressing: gypsum dressing is used to immobilize the joint for bone fractures. B. Orthes: Orthes is a special device that supports the joint and limits its mobility.
4. Physiotherapy: physiotherapy includes exercises to restore joint mobility, strengthen muscles and improve blood circulation.
5. Surgical treatment: surgical treatment may be required for complex fractures, dislocations, ligaments or meniscus.
6. Rehabilitation: Rehabilitation plays an important role in restoration after the joint injury. It includes exercises, physiotherapy and a gradual increase in the load on the joint.

III. Inflammatory joint diseases

A. Juvenile idiopathic arthritis (Yua):

1. Determination and classification: Yua is a chronic inflammatory joint disease, which begins at the age of 16 and lasts at least 6 weeks. There are several UIA subtypes that differ in the number of joint joints, the presence of systemic manifestations and forecasts.
2. The reasons for the occurrence: the causes of Yuia have not been fully studied. It is believed that the disease develops as a result of the interaction of genetic factors and environmental factors, leading to a violation of the immune system.
3. Symptoms: a. Joint pain: joint pain is the main symptom of Yua. It can be constant or periodic, intensify when moving and decreasing at rest. B. Swelling of the joints: joint edema occurs due to inflammation of the synovial shell. C. Morning stiffness: morning stiffness is a feeling of stiffness and stiffness in the joints, which lasts more than 30 minutes after waking up. D. Restriction of joint mobility: restriction of joint mobility occurs due to pain, edema and inflammation. E. Fever: fever can be observed with systemic forms of YIA. f. Raw: a rash can be observed with the systemic forms of YIA. G. An increase in lymph nodes: an increase in lymph nodes can be observed with systemic forms of the YIA. h. Use: uveit is an inflammation of the vascular membrane of the eye, which can lead to a deterioration in vision.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify the symptoms of YIA and exclude other diseases that can cause joint pain. B. Blood tests: blood tests can show signs of inflammation, such as an increase in ESR (erythrocyte settlement rate) and C-reactive protein. C. X -ray: radiography allows you to assess the condition of bones and joints and identify signs of the destruction of cartilage and bone tissue. D. Magnetic resonance imaging (MRI): MRI allows you to visualize the soft tissues of the joint and identify signs of inflammation of the synovial membrane and damage to the cartilage. E. Analysis of synovial fluid: Analysis of the synovial fluid allows to exclude infectious diseases of the joints and identify signs of inflammation.
5. Treatment: YIA treatment is aimed at reducing pain, inflammation and preventing joint damage. a. Medication: I. Non -steroidal anti -inflammatory drugs (NSAIDs): NSAIDs, such as Ibuprofen or Drowxen, are used to reduce pain and inflammation. II. Basis anti -inflammatory drugs (BPVP): BPVP, such as methotrexate or sulfasalazine, are used to suppress the activity of the immune system and slow down the progression of the disease. III. Biological drugs: biological drugs, such as FNO inhibitors (tumor necrosis factor) or interleukin-1 inhibitors, are used to block specific molecules involved in the inflammatory process. IV. Corticosteroids: corticosteroids, such as prednisone, are used to quickly reduce inflammation, but have many side effects and are not recommended for prolonged use. B. Physiotherapy: physiotherapy includes exercises to restore joint mobility, strengthen muscles and improve blood circulation. C. Cabinettherapy: Cabinettherapy helps children with YIA adapt to everyday life and perform everyday tasks. D. Surgical treatment: surgical treatment may be required to correct joint deformation or replace damaged joints.
6. Forecast: Yuia forecast varies depending on the subtype of the disease and the effectiveness of treatment. Many children with YIA manage to achieve remission, that is, the lack of symptoms of the disease. However, in some children, the disease can progress and lead to damage to joints and disability.

B. Reactive arthritis:

1. Determination: reactive arthritis is inflammation of the joints that develops after an infection, most often intestinal or urogenital.
2. Causes: reactive arthritis develops as a result of an immune reaction to infection. The immune system attacks the joints, causing inflammation.
3. Symptoms: a. Joint pain: joint pain is the main symptom of reactive arthritis. The joints of the lower extremities are most often affected, such as knee, ankle and joints of the feet. B. Swelling of the joints: joint edema occurs due to inflammation of the synovial shell. C. Morning stiffness: morning stiffness is a feeling of stiffness and stiffness in the joints, which lasts more than 30 minutes after waking up. D. Restriction of joint mobility: restriction of joint mobility occurs due to pain, edema and inflammation. E. Use: uveit is an inflammation of the vascular membrane of the eye, which can lead to a deterioration in vision. f. Skin manifestations: skin manifestations, such as psoriaz -like rashes on the skin of the palms and soles (keratoderma of Bllenic Rogika), can be observed with reactive arthritis. G. Inflammation of the urethra (urethritis): inflammation of the urethra can be observed with reactive arthritis associated with urogenital infection. h. Eye inflammation (conjunctivitis): Eye inflammation can be observed with reactive arthritis.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify symptoms of reactive arthritis and exclude other diseases that can cause joint pain. B. Blood tests: blood tests can show signs of inflammation, such as an increase in ESR and C-reactive protein. C. Analyzes for infections: Analyzes for infections, such as sowing feces for intestinal infections or tests on chlamydia, can help detect an infection that caused reactive arthritis. D. X -ray: radiography allows you to assess the condition of bones and joints and identify signs of inflammation. E. Analysis of synovial fluid: Analysis of the synovial fluid allows to exclude infectious diseases of the joints and identify signs of inflammation.
5. Treatment: Treatment of reactive arthritis is aimed at reducing pain, inflammation and elimination of infection. a. Antibiotics: antibiotics are used to treat infection that caused reactive arthritis. B. Non -steroidal anti -inflammatory drugs (NSAIDs): NSAIDs, such as Ibuprofen or Drowxen, are used to reduce pain and inflammation. C. Corticosteroids: corticosteroids, such as prednisone, can be used to quickly reduce inflammation, but have many side effects and are not recommended for prolonged use. D. Physiotherapy: physiotherapy includes exercises to restore joint mobility, strengthen muscles and improve blood circulation.
6. Forecast: The prognosis of reactive arthritis is usually favorable. In most patients, the symptoms of the disease take place over several months. However, in some patients, the disease can become chronic.

C. Septic arthritis:

1. Determination: septic arthritis is an infectious inflammation of the joint caused by bacteria, viruses or fungi.
2. The causes of: septic arthritis develops when the infection enters the joint through the blood, from neighboring tissues or during injury.
3. Symptoms: a. Joint pain: joint pain is the main symptom of septic arthritis. The pain is usually severe and constant. B. Swelling of the joints: joint edema occurs due to inflammation of the synovial shell. C. Redness of the skin above the joint: redness of the skin above the joint can be observed with septic arthritis. D. Restriction of joint mobility: restriction of joint mobility occurs due to pain, edema and inflammation. E. Fever: fever is often observed with septic arthritis. f. General malaise: general malaise, weakness and fatigue can be observed with septic arthritis.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify symptoms of septic arthritis and exclude other diseases that can cause joint pain. B. Blood tests: blood tests can show signs of infection, such as an increase in the number of leukocytes and ESR. C. Analysis of synovial fluid: Analysis of synovial fluid is the main method of diagnosing septic arthritis. It allows you to identify the presence of bacteria, viruses or fungi in the joint fluid. D. X -ray: radiography allows you to assess the condition of bones and joints and identify signs of the destruction of cartilage and bone tissue.
5. Treatment: treatment of septic arthritis is aimed at destroying infection and preventing joint damage. a. Antibiotics: antibiotics are the main method of treating septic arthritis caused by bacteria. B. Antiviral drugs: antiviral drugs are used to treat septic arthritis caused by viruses. C. Antifungal drugs: antifungal drugs are used to treat septic arthritis caused by fungi. D. Joint drainage: joint drainage is necessary to remove pus and inflammatory substances from the articular cavity. Draining can be performed using a needle or surgically. E. Immobilization of the joint: Immobilization of the joint helps reduce pain and inflammation. f. Physiotherapy: physiotherapy is used to restore joint mobility after the end of treatment.
6. Forecast: The prognosis of septic arthritis depends on the timeliness of diagnosis and treatment. With an early start of treatment, most patients recover without consequences. However, at the late beginning of treatment, joint damage and disability may occur.

IV. Other causes of joint pain

A. Lyme’s disease (borreliosis):

1. Determination: Lyme disease is an infectious disease caused by bacteria of the genus Borrelia, which are transmitted to a person through tick bites.
2. The causes of the occurrence: Lyme disease is caused by bacteria of the genus Borrelia, which are transmitted to a person through tick bites.
3. Symptoms: a. The ring -shaped erythema (migrating erythema): an annular erythema is a red spot on the skin, which appears at the place of bite of the tick and gradually increases in size. B. The flu -like symptoms: flu -like symptoms, such as fever, headache, fatigue and muscle pain, can be observed in the early stages of Lime’s disease. C. Joint pain: joint pain can occur in the later stages of Lyme’s disease. Most often, knee joints are affected. D. Neurological symptoms: neurological symptoms, such as meningitis, encephalitis and paralysis of the facial nerve, can occur in the later stages of Lime’s disease. E. Cardiological symptoms: cardiological symptoms, such as arrhythmias and pericarditis, can occur in the later stages of Lime disease.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify the symptoms of lime disease and exclude other diseases that can cause joint pain. B. Blood tests: blood tests for antibodies to bacteria of the genus Borrelia can help in the diagnosis of lime disease. C. Analysis of cerebrospinal fluid: Analysis of cerebrospinal fluid can be used to diagnose neurological complications of lime disease.
5. Treatment: Treatment of Lyme disease is aimed at destroying bacteria of the genus Borrelia. a. Antibiotics: antibiotics are the main method of treating Lyme disease.
6. Forecast: The prognosis of Lyme’s disease is usually favorable with a timely onset of treatment. However, at the late beginning of treatment, chronic complications may develop.

B. Rheumatic fever:

1. Determination: rheumatic fever is an inflammatory disease that develops after a streptococcal infection, most often tonsillitis.
2. Causes: Rheumatic fever develops as a result of an immune reaction to streptococcal infection. The immune system attacks the body’s own tissues, including joints, heart, skin and brain.
3. Symptoms: a. Joint pain (migrating polyarthritis): joint pain is one of the main symptoms of rheumatic fever. Pain usually migrate from one joint to another. B. Carder: Carder is an inflammation of the heart, which can lead to damage to the heart valves. C. Chorean Sidengam: Sidengam’s chorea is a neurological disorder, which manifests itself in the form of involuntary movements. D. The ring -shaped erythema: the ring -shaped erythema is red spots on the skin, which have an annular shape. E. Subcutaneous nodules: subcutaneous nodules – these are small solid formations under the skin, which are located above the bones. f. Fever: fever is often observed with rheumatic fever.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify the symptoms of rheumatic fever and exclude other diseases that can cause joint pain. B. Blood tests: blood tests can show signs of streptococcal infection and inflammation. C. Electrocardiography (ECG): ECG allows you to evaluate the condition of the heart and identify signs of cardias. D. Echocardiography (echocardiography): Echocardium allows you to visualize the heart and identify the defeat of the heart valves.
5. Treatment: treatment of rheumatic fever is aimed at destroying streptococcal infection, reducing inflammation and preventing heart damage. a. Antibiotics: antibiotics are used to destroy streptococcal infection. B. Non -steroidal anti -inflammatory drugs (NSAIDs): NSAIDs, such as aspirin or ibuprofen, are used to reduce pain and inflammation. C. Corticosteroids: corticosteroids, such as prednisone, can be used to quickly reduce inflammation, but have many side effects and are not recommended for prolonged use. D. Anticonvulsant drugs: anticonvulsants are used to treat chidengam chorea.
6. Forecast: The prediction of rheumatic fever depends on the degree of damage to the heart. With a timely start of treatment, most patients recover without consequences. However, with severe damage to the heart, a rheumatic heart disease can develop, which requires surgical treatment.

C. Syndrome of hyperobility of the joints:

1. Determination: joint hypermobility syndrome is a condition in which joints have increased mobility.
2. The causes of: the syndrome of hypermobility of the joints is due to genetic factors leading to a violation of the structure of collagen.
3. Symptoms: a. Joint pain: joint pain is the main symptom of the syndrome of hypermobility of the joints. Pain can occur with physical activity or after a long stay in one position. B. Subluxus of the joints: Survival of the joints is a partial displacement of the articular surfaces, which can occur in the syndrome of hypermobility of the joints. C. Clicks and crunch in the joints: clicks and crunch in the joints can be observed during movements. D. Fatigue: Fatigue can be observed with joint hypermobility syndrome. E. Skin manifestations: the skin can be more elastic and extensible.
4. Diagnostics: a. Beaton scale: Beiton’s scale is a tool used to evaluate hypermobility of the joints. B. Physical examination: A physical examination allows you to evaluate the mobility of the joints and identify other symptoms of joint hypermobility syndrome.
5. Treatment: Treatment of hyperobility syndrome is aimed at reducing pain and preventing injuries. a. Physiotherapy: physiotherapy includes exercises to strengthen muscles that support joints. B. Anesthetic drugs: painkillers, such as paracetamol or ibuprofen, can be used to relieve pain. C. Orthes: Ortheses can be used to stabilize the joints and prevent subluxation.

D. Pertes’s disease:

1. Determination: Pertes’s disease is a disease of the hip joint, in which the blood supply to the femoral head is disturbed.
2. The causes of the occurrence: the causes of Pertes’s disease have not been fully studied. It is believed that the disease is associated with impaired blood supply to the femoral head, which can be caused by injury, infection or genetic factors.
3. Symptoms: a. Pain in the hip joint: Pain in the hip joint is the main symptom of Pertes. Pain can radiate to the groin, thigh or knee. B. The limitation of the mobility of the hip joint: the limitation of the mobility of the hip joint occurs due to the pain and deformation of the femoral head. C. Close: lameness can be observed with Pertes’s disease. D. Muscle thigh atrophy: muscle hip atrophy can be observed due to limitation of mobility and reducing the load on the leg.
4. Diagnostics: a. X -ray: radiography is the main method of diagnosing Pertes. B. Magnetic resonance imaging (MRI): MRI allows you to visualize the soft tissues of the hip joint and identify signs of impaired blood supply to the femoral head.
5. Treatment: Treatment of Pertes’s disease is aimed at restoring blood supply to the femoral head and the prevention of joint deformation. a. Conservative treatment: conservative treatment includes restriction of the load on the leg, the use of crutches or wheelchair, physiotherapy and orthosis. B. Surgical treatment: surgical treatment may be required to restore the shape of the femoral head and improve the blood supply to the joint.
6. Forecast: Pertes’s prognosis depends on the age of the child and the degree of damage to the femoral head. With an early start of treatment, most children recover without consequences. However, at the late beginning of treatment, deformation of the hip joint and disability may develop.

E. Synovitis of the hip joint (transient synovitis):

1. Determination: synovitis of the hip joint is an inflammation of the synovial shell of the hip joint.
2. The reasons for the occurrence: the causes of synovitis of the hip joint have not been fully studied. It is believed that the disease can be caused by a viral infection, injury or an allergic reaction.
3. Symptoms: a. Pain in the hip joint: Pain in the hip joint is the main symptom of the synovitis of the hip joint. Pain can radiate to the groin, thigh or knee. B. Limiting the mobility of the hip joint: restriction of mobility of the hip joint occurs due to pain and inflammation. C. Close: lameness can be observed with the synovitis of the hip joint.
4. Diagnostics: a. Anamnesis and physical examination: an anamnesis and physical examination allow you to identify the symptoms of synovitis of the hip joint and exclude other diseases that can cause pain in the hip joint. B. Ultrasound examination (ultrasound): Ultrasound allows you to identify the presence of liquid in the hip joint, which is a sign of inflammation. C. X -ray: radiography allows other diseases of the hip joint, such as Pertes’s disease.
5. Treatment: Treatment of synovitis of the hip joint is aimed at reducing pain and inflammation. a. Limiting the load on the leg: Limiting the load on the leg helps to reduce pain and inflammation. B. Anesthetic drugs: painkillers, such as paracetamol or ibuprofen, can be used to relieve pain.
6. Forecast: The forecast of the synovitis of the hip joint is usually favorable. In most children, the symptoms of the disease take place within a few days or weeks.

F. Osteochondrosis:

1. Determination: osteochondrosis is a group of diseases in which the blood supply to bone tissue is disturbed in the joint, which leads to its necrosis.
2. Types of osteochondrosis: a. Osgud-Lester’s disease: Osguda-Lester’s disease is osteochondrosis of the tiger bone bugrostism, which is often found in adolescents involved in sports. B. Sheyerman-MAU’s disease: Sheyerman-Mau’s disease is osteochondrosis of the spine, which leads to the deformation of the vertebrae and the development of kyphosis (hump). C. Koenig disease: Kenig’s disease is osteochondrosis of the articular cartilage of the knee joint, which leads to the detachment of a fragment of the cartilage and the formation of a free body in the joint.
3. The causes of the occurrence: the causes of osteochondrosis are not fully studied. It is believed that diseases are associated with impaired blood supply to bone tissue, which can be caused by injury, infection