Injuries in the Pediatric Patient: Review of Key Acquired and Developmental Issues

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J Clin Chiro Peds 2009 (Dec); 10 (2): 665—670 ~ FULL TEXT

Beverly L. Harger, D.C., D.A.C.B.R., and Kim Mullen, D.C.

Department of Radiology,
Western States Chiropractic College,
Portland, Oregon

Key words:   pediatric trauma, growth plate fractures, slipped capital femoral epiphysis, incomplete fractures, torus fracture, spondylolysis, pars interarcularis defects, single photon emission computed tomography, Scheuermann’s disease, ring apophyseal fracture.

 

Introduction

A plethora of conditions specifically target children and adolescents which are not prevalent in the adult population. Understanding the age-related differences in this population can help clinicians improve diagnosis and therefore management of these conditions. Though it is beyond the scope of this paper to extensively address diseases targeting the pediatric population, common key injuries will be discussed with emphasis on the role imaging plays in establishing accurate diagnosis.

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Obesity and the musculoskeletal system

An alarming statistic in the United States is the prevalence of obesity, defined as mean Body Mass Index (BMI) greater than 95th percentile, being reported as approximately 17% in children and adolescents. [1-3] The reason for this is most likely multifactorial. Lack of physical activity, increase in caloric intake and environmental factors are all potential contributors. [2] Addressing the underlying cause of obesity in a child or an adolescent is paramount. Additionally, an important role of chiropractic clinicians is to anticipate how obesity may affect the musculoskeletal system. Several key comorbid conditions are commonly reported: slipped capital femoral epiphysis, Blount’s disease and genu varum, genu valgum, increased musculoskeletal pain, increase risk of fracture, impact on gait and function, and arthritis are most commonly reported. [2] (Table 1)

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