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

“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

Overload

If it hurts your child to step on his foot after playing sports, you should not immediately take him to the doctor. It is necessary to monitor how long the pain persists, whether the child complains of increased pain with movement, sharp or dull pain.

Due to the weakness of the musculoskeletal system, the first time after playing sports you may experience pain behind the knee and muscle soreness. These symptoms go away over time, and it is advisable to continue training with lighter loads, but not take long breaks, otherwise, after full recovery, resume going to classes, the symptoms will return.

Also, the knee joint can become overworked and hurt when overused.

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:

Classification of arthritis in children

• Infectious or reactive. It occurs against the background of previous infections: ARVI, as well as other diseases. With a general weakening of the body, infection of the joint cavity with pathogenic microorganisms occurs. Moreover, such arthritis often develops after the child has fully recovered. Source: E.I. Alekseeva, E.S. Zholobova Reactive arthritis in children // Questions of modern pediatrics, 2003, vol. 2, no. 1, p. 51—56
• Post-vaccination. This type of arthritis may be an individual reaction of the body to the vaccine. It usually occurs in children with weakened immune systems or when vaccination conditions are violated (vaccination is done during the child’s illness or immediately after recovery without observing the recommended time frame for restoring immunity).
• Viral arthritis. Appears after a child has suffered a severe viral infection: influenza, rubella, hepatitis, etc.
• Rheumatoid arthritis. Currently, it is often diagnosed in children even at a very young age. It is one of the most severe joint diseases. It most often affects children aged 1 to 6 years , and lack of proper treatment can lead to disability. At present, the exact causes of rheumatoid arthritis have not been discovered, but doctors name genetic predisposition and severe viral and bacterial diseases suffered by the child, especially streptococcal and staphylococcal diseases, as possible prerequisites. It is a known fact that the disease is autoimmune. The child’s body perceives connective tissue cells as foreign and begins to release large quantities of lymphocytes and antibodies, destroying them. There is a gradual loss of mobility. Parents should be aware that the main sign of rheumatoid arthritis in a child is prolonged joint pain, but other signs may be absent. Therefore, for any pain in the joints that lasts more than one week (even if the child experiences them sporadically), it is necessary to urgently contact a pediatrician, who will conduct an examination and refer him for treatment to a specialized specialist. Source: N.G. Muratova Modern features of rheumatoid arthritis in children // Vyatsky Medical Bulletin, 1998, No. 1, pp. 43 – 45
• Juvenile arthritis. The main cause of juvenile arthritis is a malfunction of hormonal system . The disease often affects children during puberty and the associated hormonal shift. Source: E.I. Alekseeva, T.M. Bazarova Algorithm for the diagnosis and treatment of juvenile arthritis // Issues of modern pediatrics, 2010, vol. 9, no. 6, p. 78-104

It is also necessary to add that, whatever the cause of arthritis in a child, the course of this disease is aggravated by increased stress on the joint, including during sports. Therefore, at the slightest suspicion of an inflammatory disease of the joint capsule and if a child experiences prolonged pain in the joints, it is necessary to immediately provide a gentle regime of physical activity. After diagnosis and prescription of medications and physical procedures, the doctor will give recommendations on acceptable physical activity for your child.

Multidisciplinary medical doctors have gained extensive experience in diagnosing and treating joint diseases in children. By contacting us, you will receive high-quality medical services.

Sources:

1. E.I. Alekseeva, E.S. Zholobova. Reactive arthritis in children // Issues of modern pediatrics, 2003, vol. 2, no. 1, p. 51—56
2. N.G. Muratova. Modern features of rheumatoid arthritis in children // Vyatsky Medical Bulletin, 1998, No. 1, pp. 43 – 45
3. 3. E.I. Alekseeva, T.M. Bazarova. Algorithm for the diagnosis and treatment of juvenile arthritis // Issues of modern pediatrics, 2010, vol. 9, no. 6, p. 78-104

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

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!

Diagnostics

Establishing a correct diagnosis means determining effective treatment that can restore normal functioning in the shortest possible time. First, the doctor interviews and examines the patient. Then you need to take tests to a laboratory and undergo tests using special equipment. In such cases, the following is prescribed:

• radiography;
• magnetic resonance imaging of the knee joint;
• ultrasonography;
• general and biochemical blood test;
• collection of joint fluid.

Which doctor should I contact?

When a child gets sick, parents panic and don’t know where to turn. This is why there is a family doctor. At the first examination, the doctor will determine diagnostic directions and refer you to an orthopedist, rheumatologist, infectious disease specialist or surgeon.

During the examination, it is important to check not only the knees, but also the ankle joint, foot joints, upper limbs, other joints in front and behind, at rest and during movement, to clarify whether the knee of one leg or both hurts, whether pain has appeared in both knees at the same time or alternately , is there any pain at night, is there a feeling of stiffness in the joint in the morning.

After diagnosis, individual treatment is prescribed, conservative or surgical, local in the form of ointments or creams or systemic. You should not smear your knees with various means without consulting a doctor and establishing a diagnosis, or use untested methods of traditional medicine, this can only aggravate the pathology.

Due to the complexity of the differential diagnosis of pain in the knee area, it is necessary to carry it out with special attention; if there are any unclear points, consult several specialists in different fields of medicine.

Pain behind the knee

Most often, patients complain of pain in the knee itself, but complaints of pain behind the knee are not uncommon. Such pain causes significant discomfort and can seriously limit mobility.

Causes of pain behind the knee

Determining the cause of popliteal pain is quite difficult, because it can be caused by damage to the ligaments, tendons, nerve endings, lymph nodes or cartilage of the knee.

Let's look at the most common reasons that can cause pain behind the knee.

This diagnosis can be made if the patient has severe pain behind the knee, accompanied by swelling and a tumor-like compaction under the knee that is palpable on palpation. The human joint is covered on the inside with a special synovial membrane, which produces synovial fluid - the natural lubrication of the joint. In the case of a prolonged inflammatory process, the production of fluid increases, it accumulates in the intertendinous bursa, resulting in the formation of a compaction called a Becker cyst. At first, the patient feels only mild discomfort, which, as the disease progresses, turns into a constant aching pain under the knee at the back.

Unlike Baker's cyst, a meniscal cyst cannot be detected by palpation, but requires special examinations. The pain syndrome is especially pronounced when walking or bending the leg.

It is usually diagnosed when the onset of pain behind the knee was associated with a sudden movement or injury, but in some cases it can be the result of arthrosis. Quite often it requires surgical treatment.

Nagging pain behind the knee is often the result of inflammatory bursitis and tendinitis. The onset of symptoms is usually preceded by prolonged physical activity.

A fairly common occurrence when playing sports. The most common injury is sprains, but more serious injuries are also possible. Sprains are usually accompanied by sharp pain behind the knee with any movement, as well as when pressing on the damaged area.

It occurs as a result of infection through a wound, inflammation and an increase in the size of the popliteal lymph nodes.

Inflammation of the tibial nerve

A large nerve that runs along the bottom of the popliteal fossa and can become inflamed for a variety of reasons. In this case, sharp and intense pain behind the knee occurs when walking, bending the leg, or any other load, spreading along the leg all the way to the foot.

Popliteal artery aneurysm

A rather rare disease in which constant nagging and throbbing pain is felt. A small pulsating lump may be felt under the knee.

Pain caused by pinched or inflamed nerves of the lumbosacral region and radiating to the legs.

Treatment of pain behind the knee

Since the causes of pain can be different, the treatment is significantly different:

1. Regardless of the reason, it is recommended to reduce the physical load and provide the sore knee with a gentle regime.
2. In most cases, especially with inflammation and injuries, special orthopedic pads or fixing bandages are used.
3. For sprains, external anti-inflammatory ointments and creams are used.
4. In the case of Becker's cyst, as well as in inflammatory diseases, injections of non-steroidal anti-inflammatory drugs and glucocorticosteroids are usually used.
5. If necessary, surgical intervention is performed. Thus, surgery is often necessary for injuries and tears of the meniscus. The popliteal abscess is surgically opened and the inflammation of the nerve is treated. Surgery is also required for aneurysms.

Congenital diseases

Some pathologies appear even in infants, as they are inherited genetically congenital diseases.

Such pathologies are rare and incurable; symptoms can be stopped, allowing patients to lead a normal life.

One example is Marfan disease, which affects not only joints, but also internal organs. Due to disruption of connective tissue protein synthesis, the structures of the skin, joints and muscles, including the myocardium, suffer. The joints become very flexible, but fragile.

Infection

Various bacteria can cause inflammation of the knee joint and the tissues around it, manifesting itself as

• Tendonitis (tendons),
• Ligamentites (ligaments),
• Bursitis (bursae),
• Arthritis (the joint itself),
• Myositis (muscles),
• Osteomyelitis (specific inflammation of bone tissue).

Important distinguishing symptoms are the following:

• The presence of toxic-infectious syndrome, increased body temperature, chills, headache, loss of appetite;
• At the same time, the limb in the joint area turns red, swelling appears, and difficulty moving;
• The occurrence of acute pain, the knees constantly hurt at night even at rest.