Pediatric clinics of North America
-
Pediatr. Clin. North Am. · Oct 1996
ReviewPediatric knee. Clinical assessment and common disorders.
Knee pain and injury are commonly seen in children and adolescents. A comprehensive evaluation of the knee is built on an appreciation of the anatomy, biomechanics, and pathophysiology of common disorders. This article considers these issues and describes a sequential technique for physical examination of the knee. Relevant imaging options and management strategies also are discussed.
-
Pediatric fractures are seen commonly in emergency departments. Pediatricians are usually the first physicians to assess injured children. ⋯ Musculoskeletal injuries, fractures, and sprains are common, most of which require minimal care. Growth plate injuries, however, pose a risk for permanent deformity and must be managed with care.
-
Fractures are one of the most common manifestations of child abuse. Pediatricians and other physicians caring for children must have a clear understanding of the injury patterns sustained by children in abusive situations and be able to recognize those injuries. A thorough history and physical examination and accurate radiographic interpretation are essential. Early identification of nonaccidental trauma is imperative because proper intervention has been shown to be effective.
-
Improvements in diagnosis and treatment have increased survival for many children with malignant bone tumors. New molecular genetic discoveries are providing insights into the mechanisms of tumorigenesis and may provide novel therapeutic modalities based on interfering with aberrant transcriptional activation by hybrid transcripts.
-
Oxidant stress seems to be involved in the pathogenesis of several important gastroenterologic disorders in infants and children. The question can still be asked, in most circumstances, whether the oxidant stress precedes, and therefore is involved in, tissue or cellular injury or is a result of injury and not of clinical importance. The data favor the former situation in several inflammatory conditions of the bowel and in a variety of liver diseases. Experimental and clinical testing of this possible basic mechanism of tissue injury over the next few years will shed light on the role of antioxidants in treating gastrointestinal disorders.