Your Child’s Health Bone and Joint Disorders

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Scoliosis is an abnormal sideways curvature of any part of the spine, and most commonly occurs in preadolescent girls. The cause of scoliosis in this group of children is unknown. Rarer causes of scoliosis include cerebral palsy and muscular dystrophy.

Scoliosis is usually discovered during routine screening at school. It rarely causes problems during childhood, but the curvature of the spine is visible in most cases. Pain may occur at a later stage.

Investigations

Most children who are thought to have scoliosis will undergo an X-ray of the spine to confirm the diagnosis. X-rays may be repeated at certain intervals to monitor the degree of scoliosis as the child grows.

Treatment

Most mild cases of scoliosis will not require specific treatment, but the child should be monitored routinely to see how the condition is progressing. A more severe curvature may require some form of temporary back brace to minimize the deformity. This will be done under the supervision of an orthopedic surgeon. Surgery is only necessary in the most severe cases.

When to see your doctor

See your doctor if you are concerned that your child may have scoliosis.

Clubfoot is a deformity of the foot which is present at birth. The baby’s foot is turned inward, with the inner edge turned upwards. The calf muscles may be poorly developed. This condition occurs in approximately 1 in 1000 births. The cause is uncertain, but the condition is probably due to an abnormality of the developing bones and ligaments. Talipes has a tendency to run in families.

The child with talipes should be referred to a pediatric orthopedic surgeon. Treatment to correct the position of the foot is commenced soon after birth. Special splints or plaster casts are used to hold the foot in a straight position. Careful follow-up is essential, as the condition may recur. Surgery is sometimes necessary.

This condition is different from talipes calcaneovalgus (‘turned’ foot), which is more common and usually of no consequence. Here the toes are turned upwards towards the shin, and the whole foot is turned to the outside.

This is the most common foot abnormality seen in the newborn. In the majority of cases, the condition corrects itself within 6 months and no treatment is required. Occasionally stretching and splinting is necessary. This condition is associated with congenital dislocation of the hips, so the hips must be carefully checked.

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