Knee pain in childhood and adolescence is relatively common, it can be caused acutely by an injury or as an independent disease of the growing skeletal system.
Typical age-related diseases of the knee joint are easily treatable with a correct and quick diagnosis and rarely cause late consequences. Diagnosis is often difficult because children usually cannot remember injuries accurately, describe symptoms inaccurately, and often cannot locate them well. It is therefore important to avoid hip joint diseases (acetabular rhinitis, acetabular cup loosening, Perthes disease) or other systemic diseases such as e. B. infantile rheumatism, exclude blood diseases.
In addition to the clinical examination of the knee joint, the evaluation of the gait pattern, motor development, analysis of the rotational and axial relationships of the leg, ligament stability and activity level with sports loads should be inquired about.
Further clarification may be necessary with ultrasound, X-ray or even MRI. I give you a brief overview of the causes. Treatment options for the most common knee joint disorders in childhood. This is the most common disease in the knee region in the growing skeleton. Affects mainly athletically active boys between 11 and 15 years of age. It comes mostly conditioned by microtraumatisations. Due to the unbalanced shortened musculature to a build-up disorder at the tibial head. Typically, load-dependent pain with local swelling, redness, and tenderness. Ultrasound and X-rays show typical changes in the bone.
Therapy consists of adaptation of sports activity, local therapy, immobilization is rarely necessary. The disease is self-healing. Self-limiting.
Osteochondritis dissecans of the knee joint .
. is a chronic, often in boys occurring, localized circulatory disorder in the inner load zone of the femur with a stadium-like progression, in 10 % also occurring bilaterally. The cause is still not exactly known. There is load-dependent knee pain with partial swelling and effusions with inconspicuous clinical findings, in this case further clarification with X-ray and MRI is necessary.
Therapy is required before the 14. In the second year of life, mostly conservative with relief and abstinence from sports. After that, depending on the stage of the disease, surgical therapy with drilling of the affected area or refixation is necessary if the fragment (joint mouse) comes loose.
The anterior knee pain (chondropatia patellae, patellar tendinitis)
Anterior knee pain subsumes a number of different clinical pictures that are caused by or project to a change in the patellar bearing. Symptoms can begin as early as elementary school age. Have an accumulation in adolescence. Affected are often girls from the age of 13. year of life. There is load-dependent pain in the area of the kneecap, usually on both sides.
It is primarily a functional problem due to a muscular imbalance with shortening of the muscles leading to the knee in combination with overuse. The discomfort is aggravated by climbing stairs, prolonged sitting or even knee bending.
Due to the favorable spontaneous course of this disease with complete freedom from symptoms without specific therapeutic measures, it is possible to wait a while, otherwise a series of physiotherapy with stretching and strengthening of the muscles near the knee is useful.
popliteal cyst and disc meniscus
The popliteal cyst usually occurs spontaneously in children between the ages of 4 and 18. and 8. This condition occurs at the age of 50, is usually asymptomatic and is not associated with knee joint disease. Treatment is conservative, as the cysts disappear spontaneously in the natural course after 1 to 2 years; surgery is only very rarely necessary.
The cause of the disc meniscus is largely unknown. The typical symptom in young patients is the snapping knee, the children complain of blocking and subluxation sensation with only slight painfulness.
In older children and adolescents symptoms of meniscus tear with pain, swelling and entrapment may occur, in this case further clarification by MRI is necessary and usually also surgical therapy. The kneecap becomes muscular. bones led. Bony deformities, muscle and ligament weakness as well as systemic diseases or traumatic effects can lead to instability and dislocation of the patella, mostly to the outside.
In the clinical examination, a so-called hypermobile patella is diagnosed when the patella can be clearly shifted outwards or even spontaneously has the tendency to slide outwards. In this case, a detailed examination with gait analysis, assessment of the leg axis, knee joint stability and the generalized ligament situation is necessary. Likewise, changes in the hip-. Foot area to be clarified. Patellar instability must subsequently be clarified with X-ray and MRI.
The initial dislocation is also, depending on the basic situation, usually treated conservatively. However, if more than 2 to 3 spontaneous dislocations occur, a surgical therapy with stabilization of the patella should be considered in further consequence, otherwise the patella dislocations can also cause damage to the patellar bearing and premature arthrosis. The acute as well as chronic knee pain in the child-. Adolescence can have a wide variety of causes. Most symptoms are non-specific and often do not lead to a clear diagnosis after a thorough clinical examination. A further clarification is obligatory after longer existing pain. The therapy is based on the diagnosis, which covers a wide spectrum from a cautious observation of the spontaneous course of the disease to a possibly necessary surgical intervention.