Knee problems can occur at any age. They may arise due to developmental defects, diseases or injuries. Childhood knee problems can cause deformity, swelling or pain--the latter being the most common. Bow legs and knock-knees are self-limiting, developmental abnormalities that appear in toddler years. Knee pain is a frequent complaint mostly in the teen/adolescent years. Pain can be caused by several conditions, the chief ones being patellofemoral pain syndrome, patellar subluxation, Osgood-Schlatter disease, patellar tendinitis and osteochondritis dissecans.
Knee Joint
The knee joint consists of the ends of three bones--tibia, or the shin bone; femur, or the thigh bone; and patella, or the knee cap, explains the website for the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The joint cavity contains synovial fluid and is lined by synovial membrane. Articular cartilages cover the bone endings. In between these bone endings, there are shock absorbers called menisci. Ligaments and muscle tendons cover the joint. Thigh muscles, or quadriceps, and the muscles on the back of the thigh, or hamstrings, support the knee joint. Problems involving any of these parts may cause symptoms in the knee joint.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome occurs especially in adolescent girls and causes dull pain around and behind the knee cap, notes a 2007 article in "Pediatric Rheumatology Online Journal." The pain aggravates during and after weight-bearing exercises, descending stairs and prolonged sitting. The risk factors include joint overuse; mechanical malalignment of leg and knee bones, which can make the knee cap move abnormally; and weak thigh muscles. Pain medication, temporary rest from the pain-aggravating activities and muscle-strengthening exercises help to lessen the pain. The pain will resolve gradually. If the pain continues, visit your pediatrician for further management.
Patellar Subluxation
Patellar subluxation, or partial dislocation of the knee cap, is also common in teenage girls, notes the American Academy of Family Physicians. It causes knee pain and giving way episodes. There may also be locking and catching sensations in the knee. The contributing factors include malalignment of the bones in the joint and imbalance in the forces of thigh muscles. Treatment consists of muscle exercises and splints for the knee. Surgery may be required if there are recurrent episodes or when there is patellar dislocation.
Osgood-Schlatter Syndrome
Osgood-Schlatter syndrome is common in adolescent boys participating in sports. It causes pain and tenderness just below the knee cap. The pain increases with activity and decreases after taking rest. It may last for several months but will go away when the child is out of his adolescent growth spurt phase.
Patellar Tendonitis
Also called jumper's knee, patellar tendonitis is common in teenage boys, as well. Activities such as jumping and hopping cause the pain, reports the National Institute of Arthritis and Musculoskeletal and Skin Diseases. There may be tenderness just below the knee cap, where the patellar tendon attaches to the shin bone. Rest, ice and muscle-strengthening exercises improve the condition.
Osteochondritis Dissecans
Osteochondritis dissecans occurs due to loss of blood supply to the bone, which leads to degeneration of the cartilage and bone. Pain and swelling occur with activity. Also, there may be tenderness by the side of the knee cap. Your pediatrician may recommend X-rays when this condition is suspected. In a 2008 study conducted by scientists at Cincinnati Children's Hospital and published in "The Journal of Bone and Joint Surgery," activity restriction and knee bracing healed the condition, though about one-third of patients required surgery. If left untreated, it may lead to osteoarthritis.
Others
Direct trauma can result in bone fractures. Ligament injuries occur due to sudden twisting motions, such as those that basketball players use. Immediate care with rest, ice, pain medication and a prompt visit to the pediatrician is the best approach for any injuries, advises KeepKidsHealthy.com.
Several relatively uncommon conditions can cause knee problems in children, including juvenile rheumatic arthritis, septic arthritis, cysts, tumors, etc. Visit your pediatrician if the pain does not go away with simple care at home. Your pediatrician may do several tests to come to a definitive diagnosis and provide appropriate treatment.
References
- National Institute of Arthritis and Musculoskeletal and Skin Diseases: Knee Problems
- PubMed Central: Review for the Generalist: Evaluation of Anterior Knee Pain
- American Academy of Family Physicians: Evaluation of Patients Presenting with Knee Pain
- PubMed Central: The Healing Potential of Stable Juvenile Osteochondritis Dissecans Knee Lesions
- KeepKidsHealthy.com: Knee pain
