Rheumatology Apophysitis in children

Apophysitis in children Mojgan Faraji Goodarzi Pediatric Rheumatologist, Lorestan University of Medical Sciences Apophysitis is an inflammation or stress injury to the growth plate where a muscle or tendon attaches to it. It is commonly seen in active, growing children and adolescents. Apophysitis is usually caused by repetitive activities like running, jumping, and throwing but can also occur as an acute injury with a fall or rapid, powerful movement. The most common types of apophysitis are Sever's Disease, Osgood Schlatter's Disease, Iliac crest apophysitis, Sinding-Larson-Johansson syndrome and Iselin's Disease. Osgood-Schlatter disease is an apophysitis of the proximal tibial tubercle at the insertion of the patellar tendon. Sever's Disease is inflammation on the growth plate at the insertion of the Achilles tendon that is located on the posterior inferior aspect of the calcaneus. The most common risk factors for apophysitis are periods of rapid growth and also repetitive activities in young athletes who play sports or perform activities such as running, jumping, or throwing. Apophysitis will usually presents with pain that worsen with activity and improves with rest. There is almost always local tenderness at the site of the apophysis. A "bump" may be seen. It sometimes causes limping. Common sites include the knee, heel, elbow, hip, and pelvis. A physician may make the diagnosis of apophysitis by history, physical examination, and x-rays. An X-Ray can be ordered if there is a need to differentiate it from an acute avulsion. The mainstay of treatment is controlling the pain and inflammation, initially by reducing the activity in sports, gym, or free play. The patients are advised to have "relative rest" for ۱-۲ weeks. NSAIDs may be of benefit for a short course (۱ week). Another treatment is Intermittent ice applied to the area. In severe cases, a short period of absolute rest and/or immobilization of the body part may be necessary with using cast, Braces or medical equipment. Surgery is rarely necessary. Rehabilitation or special exercises may be necessary prior to returning to sports.

کلیدواژه ها:

Apophysitis ، Sever's Disease ، Osgood Schlatter's Disease