Orthopedic Conditions in Children
WHAT IS AN IRRITABLE HIP?
There are probably two sorts of irritable hip. The most common type is caused by fluid in the hip joint that interferes with the normal movement of the hip. This fluid can be shown by an ultrasound scan of the hip, though the findings on examination are usually enough to make the diagnosis.
The second type probably results from inflammation of glands in the tummy from a viral infection.
Your child has been referred to the clinic because of his/her heel pain. Examination and X-rays have shown no serious disease. The pain is due to a condition called "Sever's Disease". This leaflet tells you about Sever's Disease.
WHAT IS SEVER'S DISEASE?
It is not really a disease at all. It is a type of growing pain, which protects your child's growing skeleton from damage caused by over activity at a time when rapid growth of the heel bone makes the bone weaker than normal.
Your child walks with his/her feet turned in or intoed. Some call this hen toeing or pigeon toeing. The problem appears to be in the feet but careful examination reveals that the whole leg, not just the foot, is turned in the way. The in-turning is at the hip. This may also give the appearance of knock- knees.
Many intoers seem rather clumsy and fall a lot. Intoers commonly have loose joints or "ligamentous laxity". It is easy to show by examination that the joints are loose and that the hips can be turned in more than out.
WHAT IS A POPLITEAL CYST?
A popliteal cyst is a benign fluid-filled lump that appears at the back of the knee in some children. It connects with a cyst that we all have at the back of our knees. This cyst oils the hamstring tendons as they move over the back of the knee so they don't fray through. The cyst has a fancy name - the semi-membranosis bursa - but most people find "popliteal cyst" less of a mouthful!
Leg pains seem to occur in almost all children at some stage during growth. They are often known as growing pains though growth itself is not painful. We call these Benign Leg Pains because the pains do not cause long term problems even if they can be quite distressing at the time. There are two different patterns of leg pains. The first seems to occur in a very active child in the evening after excessive running about. The second occurs in the middle of the night when the child awakes screaming in pain, which they may localize to a foot or knee or hip.
Minor toe abnormalities are common. Parents often think that a toe abnormality is the reason their child is slow or reluctant to walk. This is never the case. Some toe problems are discussed below.
OVERRIDING SECOND TOE
CURLY THIRD AND FOURTH TOES
OVERRIDING FIFTH TOES
WHAT IS KNEECAP PAIN?
Kneecap pain is pain that comes from the kneecap or patella. It is usually felt at the front of the knee though it sometimes seems to spread around the sides and occasionally to the back of the knee. Many different names have been given to this type of knee pain including anterior knee pain, chondromalacia patellae and patello-femoral pain. Patello-femoral pain is most in favour at present with doctors.
WHAT ARE FLAT FEET?
A foot is described as flat if the arch on the inner border of the foot is not as high as normal. This may also give the appearance that the ankle bone on the inside is more prominent or that the whole foot seems tilted out the way.
Your child has been referred to the clinic with either bow-legs or knock-knees. This leaflet has been prepared to help you learn more about these related conditions. Bow-legs means that there is a gap between the knees when the ankle bones are pressed together. Knock-knees are present when there is a gap between the ankle bones with the knees are pressed together.
ARE BOW-LEGS OR KNOCK-KNEES ABNORMAL?
NOT IN MOST CHILDREN.