Makindo Medical Notes.com

Acute joint pain and swelling in children can arise from a variety of causes, including trauma, infection, and inflammatory conditions. Identifying the underlying cause is crucial for effective management.

Approach to Acute Joint Pain and Swelling in Children

The clinical approach to evaluating a child with acute joint pain and swelling involves a thorough history, physical examination, and appropriate investigations. Key steps include:

History and Examination

• Onset, duration, and characteristics of pain.
• Associated symptoms (fever, rash, fatigue).
• Recent trauma or infections (e.g., respiratory or gastrointestinal infections).
• Family history of autoimmune or inflammatory conditions.
• Examine the affected joint(s) for warmth, redness, tenderness, and range of motion.
• Assess for systemic signs (e.g., fever, lymphadenopathy).
• Check for signs of trauma (e.g., bruising, deformity).

Common causes include

Investigations

• Blood Tests: Full blood count (FBC), inflammatory markers (CRP, ESR), and blood cultures in suspected infection.
• Joint Aspiration: If septic arthritis is suspected, aspiration of joint fluid for analysis (WBC count, culture) is crucial.
• Imaging: X-ray or ultrasound may be needed to assess for fractures, dislocations, or effusions.

Management

• Infection: Prompt antibiotic therapy for septic arthritis. Surgical drainage may be necessary.
• Inflammatory Conditions: Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids for inflammatory arthritis.
• Trauma: Immobilization, pain relief, and possible orthopaedic intervention for fractures or ligament injuries.
• Supportive Care: Rest, analgesia, and follow-up with specialists as needed (e.g., rheumatologists or orthopaedic surgeons).