Knee Problems in Children

Introduction:

In kids, there are many causes of knee problems, but overuse of the knee is the commonest cause. The joint that unites the thigh bone (femur) to the top of the shin bone (tibia) is named the knee joint. The knee joint helps in walking and bending of legs. This article will focus on the key features of knee problems in children, signs and symptoms, diagnosis, the role of parents, and the role of the doctor.

Why Are Kids More Susceptible to Knee Injuries?

Kids are more likely to get a knee injury because:

• Anatomy: Anatomically the knee joint of kids is very small and very sensitive to any stress like overuse or training. For example, children may be more prone to patellar dislocation due to the shape of their femur and tibia bones.

• Fall: It is common for them to suffer knee joint problems during their growing years as they fall or if there is a twisting of the knee.

• Physical Activity: Children are more active than adults and engage in sports that can put additional stress on their knees.

• Bone Density: Children's bones are less dense than adults, making them more susceptible to fractures or injuries.

Following are some causes of knee problems in kids:

1. Improper balance of thigh muscles.

2. Injuries.

3. Poor flexibility in muscle movement.

4. Malalignment of muscles that support the knee.

5. Vigorous sports training activities (twisting, bending, or falling on knees).

6. Exaggerating sports activities.

7. Overuse of the knee (climbing stairs and kneeling).

8. Infection (bacterial) leads to osteomyelitis and septic arthritis.

9. Autoimmune disorders (juvenile arthritis).

10. Other causes involve jumper's knee, soft tissue knee injuries, patellofemoral syndrome, and quadriceps tendinitis.

11. Muscle sprain (tendonitis, meniscal tears, ligament injuries, bursitis).

12. Tumors.

13. Malignant and benign tumors can cause pain in the knee. Pain and swelling can also be present.

What Are the Signs and Symptoms of Knee Pain?

The followings are the signs and symptoms of knee pain:

• Knee not being able to support the body weight.

• Knee caps will not be in their position.

• Unbearable painful crackling and popping noise.

• The knee will be locked in its position.

• Swelling of joints.

What Are the Ways to Diagnose?

Knee problems in a baby can be diagnosed by:

• The doctor will ask certain questions, including history.

• The doctor will physically examine the knee, which includes touching the knee and moving them in certain directions.

• X-Rays: X-rays may be useful in detecting abnormal bone structure in the bone area.

• MRI (Magnetic Resonance Imaging): This scan is used to provide accurate images inside the body.

• CT Scan (Computerized Tomography): This scan can provide pictures of the knee joint from various angles.

• Blood Report: Certain blood tests may detect elevated blood markers or an increase in white blood cells following an injury.

Differential Diagnoses Include the Following:

1. Growing Pain:

Growing pains are commonly seen in children. Its key features are:

• Kids from ages three to 12 years have this pain.

• Pain rises in the evenings and is felt in both legs, in front of thigh muscles or the calves, or behind the knees.

• The pain represents itself without any sign of external injury or swelling.

• Pain is not associated with infection or any limping.

• Generally, growing pain will go away without any medical assistance.

• Contact a pediatrician to confirm the diagnosis.

In the presence of bacterial infection in neonates and infants, symptoms include general irritability, and there will be a refusal to walk, and limited limb movements.

2. Osgood Schlatter's Disease:

Osgood-Schlatter’s Disease (OSD) is a common condition affecting the knee joint in children and adolescents. It is caused by repetitive stress on the growth plate of the tibia. It is an inflammation in the knee region where the shin bone attaches to the knee cap. It occurs in puberty. It is commonly seen with children actively involved in sports. OSD typically affects boys and girls between the ages of 10 and 15, during a period of rapid growth and increased physical activity.

What Are the Treatments Available?

1. RICE:

Rest - Make sure that the child is well rested. Always support the knee by keeping the legs on the pillow.

Ice - Icing the knee will keep down the swelling.

Compressions - Bandage the knee (especially elastic bandages) as per the doctor’s advice.

Elevation - Keep the knee elevated. It aids in keeping the swelling down.

2. Physical Therapy And Exercises: Physical therapy and exercises are provided by physiotherapists. Examples are quadriceps stretches knee-to-chest, and leg raises.

3. Non-Steroidal Anti-inflammatory Drugs: Aspirin is contraindicated in children. Over-the-counter medicines like Ibuprofen can reduce pain. Always check with the doctor before giving it to children.

4. Knee Braces: Knee braces can be used to support and stabilize the knee joint in children with knee problems. Consultation with a pediatric orthopedic specialist is important to select the appropriate type of brace for the child's specific condition. Knee braces should fit properly and be comfortable for the child to wear, and consistent use is essential for optimal benefit.

5. Gentle Massages: Gentle massages can be beneficial for children with knee problems. Massages should only be performed by a trained and licensed professional. Parents should not perform massages on their children without proper training or guidance.

Children can also be cared for at home by the parents in the following ways:

• Parents must read the labels on the medicine for instructions.

• Parents must give the medicines to the children on time and as prescribed by the doctor.

• Keep the child adequately rested.

• Keep ice or an ice pack on the child's knee for ten to fifteen minutes.

• Keeping the knee elevated (above the heart level) will help to reduce the swelling.

• If the knee is not swollen, a warm cloth on the knee can be placed.

• Make sure to wear elastic bandages, sleeves, or any other support for the knee if the doctor has prescribed it.

• Take guidance from the doctor about how much weight the child can put on the knee.

• Any activity or exercise can be done under the doctor's advice.

• Take small steps: If the child is doing a mild activity, slowly increase the pace.

• Regulate the child's weight. Excess weight can produce a lot of strain on the joint.

After trying all the things if the pain of the children does not go away. Call for help for the following reasons:

• Pain does not go down even on medication and keeps increasing.

• If the child's leg or foot turns pale.

• If the foot of the child is getting colder.

• If the child's knee cannot bear the child's weight.

• If the pain aggravates at night.

• If the child's kneecap feels out of its place.

• Persistent high fever.

• Significant weight loss.

• If the joint is swollen, red, or tender on touch.

The doctor should be visited for all the above-mentioned reasons. The pediatric doctor will recommend the child to an ortho specialist. Further treatment will proceed as per the orthopedic doctor. Pediatric orthopedic specialists have specialized training and expertise in treating children with knee problems, including a wide range of conditions such as ligament injuries, patellar dislocation, knee pain, and other issues. They are trained to evaluate the specific needs of children and provide age-appropriate treatments and interventions.

How to Prevent Knee Pain?

• Normally, knee pains are treated with regular exercise and warm-ups before any sports activity.

• Weight loss regimen to be followed if children are obese and have knee problems.

• Always let the child do warmups before any sport.

• Make children do regular exercise to decrease any chance of knee injury.

• Make them learn to bend their knees before landing and jumping.

• Shoes should be appropriate concerning the sport. Also, wear knee pads if required.

• In-depth training (at least one year) should be provided to avoid any chance of injury, especially in football, soccer, or tennis.

• Avoid running downwards (for example, down the hill) as it can put extra pressure on their knees and damage the knee joint.

• Keep the joint lubricated by drinking ample water.

• Practice yoga to improve the strength and flexibility of the joint.

Conclusion:

The knee joint comprises complex structures. Parents must understand what is normal or abnormal. Treatment for knee problems will help, so do not wait for it to grow out. Early diagnosis and early intervention can help to resolve knee problems. A physical therapist guides and teaches the methods to strengthen the knee joint. Always follow the instructions of the doctors.