Leg Pains in School-Aged Children: Week 9 Discussion Essay
Leg Pains in School-Aged Children: Week 9 Discussion Essay
Leg Pains in School-Aged Children: Week 9 Discussion Essay
Pediatric populations sustain various common musculoskeletal injuries and fractures, including lateral ankle injuries, ankle sprains and nondisplaced distal fibula fractures (Beck et al., 2020). This discussion presents a case study based on common musculoskeletal injuries in the pediatric population. The case study involves a 7-year-old male with leg pains that began a week ago, appearing at night. However, the patient has no pain during the day, movement restrictions, history of trauma, fever, or joint swelling. His family history lacks rheumatic or collagen vascular disease, and his physical examination is unremarkable. Based on this information, the discussion will include three differential diagnoses, laboratory studies, the difference between musculoskeletal injuries in children and adults, the extent of diagnostic work-up, common fractures in pediatric patients, and treatment of one of the differentials.
ORDER A PLAGIARISM-FREE PAPER HERE
The three possible conditions for this patient and other school-aged children are restless leg syndrome (RLS), growing pains and nocturnal leg cramps. According to Vlasie et al. (2022), restless leg syndrome is characterized by restlessness and pain, mainly occurring during the night and eased by movement. RLS is a central nervous system disorder that causes morphologic changes in the motor cortex, thalamic grey matter and somatosensory cortex, thus causing pain and inhibiting leg movement. Growing pains are intermittent bilateral leg aches that occur at night. According to Pavone et al. (2019), the etiology of growing pins remains unknown. However, rowing pains cause limb pins, mainly in the front of the thighs, the calves or behind the knees. The pathophysiology of nocturnal leg cramps also remains uncertain, despite being associated with various medications and diseases.
The only radiographic test necessary for children with leg pains is an x-ray. X-rays are used to determine whether there is any abnormality with the bones, joints, and soft tissues. They are also used to identify fractures and various infections. Musculoskeletal injuries in children differ from musculoskeletal injuries in adults based on the injury type and location. According to Beck et al. (2020), musculoskeletal injuries in children mainly occur on the ankles, wrists and elbows. On the other hand, injuries in adults mainly occur on the hips. Musculoskeletal injury types in children include sprains, strains, and repetitive motion injuries, while in adults, the most common injuries are fractures and back pains.
Nurse practitioners decide the extent of the diagnostic work-up in a child with extremity pain using the physical assessment results, severity and type of the pain, symptoms presentation and the diagnostic test results. For instance, a physical examination can help identify a visible abnormality, such as a bent joint. Diagnostic tests such as x-rays can also inform diagnostic work-up by identifying an infection or a fracture. According to Wolfe et al. (2019), the most common pediatric fractures include forearm and humerus fractures for children under five years, greenstick fractures for children aged 5-10, and phalanx figure fractures for children aged 9-12.
The diagnosis for the patient, in this case, is growing pains. Growing pains are associated with lower pain thresholds and may not necessarily require specific pharmacological treatment. However, the patient can use common medications to reduce pain, such as Paracetamol. Non-pharmacological interventions such as massage, a warm bath, or warm heat packs can also relieve the pain. However, when the pain persists, the patient should seek specialized attention, such as orthopedics.
References
Beck, J. J., VandenBerg, C., Cruz, A. I., & Ellis, H. B. (2020). Low energy, lateral ankle injuries in pediatric and adolescent patients: a systematic review of ankle sprains and nondisplaced distal fibula fractures. Journal of Pediatric Orthopaedics, 40(6), 283-287. https://doi.org/10.1097/BPO.0000000000001438
Pavone, V., Vescio, A., Valenti, F., Sapienza, M., Sessa, G., & Testa, G. (2019). Growing pains: What do we know about etiology? A systematic review. World Journal of Orthopedics, 10(4), 192–205. https://doi.org/10.5312/wjo.v10.i4.192
Vlasie, A., Trifu, S. C., Lupuleac, C., Kohn, B., & Cristea, M. B. (2022). Restless legs syndrome: An overview of pathophysiology, comorbidities and therapeutic approaches (Review). Experimental and Therapeutic Medicine, 23(2), 185. https://doi.org/10.3892/etm.2021.11108
Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early pediatric fractures in a universally insured population within the United States. BMC Pediatrics, 19(1), 1-6. https://doi.org/10.1186/s12887-019-1725-y
ORDER A CUSTOM PAPER NOW
Clinical Case Scenario:
A 7-year-old boy has a one-week history of leg pains. He wakes up at night and cries because his legs hurt; however, during the day, he feels fine with no pain and no movement limitations. He has no history of trauma, fever, or joint swelling. The family history is negative for rheumatic or collagen vascular disease. The boy’s height and weight are at the 50th percentile for age, he is afebrile, and the physical examination is unremarkable.
Questions
What are 3 differential diagnoses of leg pains in school-age children? Include the pathophysiology of the 3 differentials.
What laboratory or radiographic studies are appropriate for children with leg pains? Explain
How do musculoskeletal injuries in children differ from those in adults? In terms of injury type and location.
How does the nurse practitioner decide the extent of the diagnostic work-up in a child with extremity pain?
What fractures are common in pediatric patients, and what are the ages associated with them?
Choosing one of the diagnoses you’ve come with; how would you treat the condition?
