Chapter 48: Musculoskeletal & Joint Disorders in Children

Musculoskeletal & Joint Disorders in Children details the systemic consequences of inactivity, including muscle atrophy, bone demineralization leading to osteoporosis, cardiovascular changes such as orthostatic intolerance, and the risks of skin breakdown, alongside the psychosocial impacts of sensory deprivation and loss of autonomy. The text explores traumatic injuries, distinguishing between soft-tissue damage like contusions, sprains, and strains treated with RICE (Rest, Ice, Compression, Elevation), and various pediatric fracture types such as greenstick, buckle, and spiral fractures, with specific attention to Salter-Harris growth plate injuries. Critical nursing assessments for complications like compartment syndrome—monitored via the six Ps: pain, pulselessness, pallor, paresthesia, paralysis, and pressure—are outlined alongside management strategies involving casting (including spica casts) and traction modalities like Bryant, Buck, and halo vests. The chapter further examines congenital and developmental defects, including Developmental Dysplasia of the Hip (DDH) managed with Pavlik harnesses, congenital clubfoot treated via the Ponseti method, and genetic disorders like Osteogenesis Imperfecta characterized by bone fragility. Acquired conditions such as Legg-Calvé-Perthes disease, Slipped Capital Femoral Epiphysis (SCFE), and spinal deformities including kyphosis, lordosis, and idiopathic scoliosis requiring bracing or spinal fusion are thoroughly reviewed. Finally, the discussion encompasses infectious processes like osteomyelitis and septic arthritis, as well as chronic autoimmune inflammatory disorders including Juvenile Idiopathic Arthritis (JIA) and Systemic Lupus Erythematosus (SLE), detailing pharmacologic interventions with NSAIDs, DMARDs, and biologics to preserve function and prevent disability.