Pediatric emergency medicine trisk 1162 1162

TABLE 60.2
COMMON CAUSES OF JOINT PAIN
Septic arthritis (bacterial)
Osteomyelitis
Kawasaki disease
Lyme disease
Transient synovitis
Postinfectious (reactive)
Traumatic
Serum sickness
Henoch–Schönlein purpura

Trauma
A key initial point in the history is whether trauma preceded the pain. A
radiograph will detect fractures or a slipped capital femoral epiphysis (SCFE).
Classically, an SCFE occurs in the obese adolescent with hip or knee pain
(Chapters 111 Musculoskeletal Trauma and 121 Musculoskeletal Emergencies ).
Importantly, only about half of children will report preceding trauma and there
may be bilateral disease in about one-third of children. Plain radiographs
(including the frog-leg view of the hip) showing a widened epiphysis and caudal
displacement of the femoral head establish the diagnosis.
TABLE 60.3
LIFE-THREATENING CAUSES OF JOINT PAIN
Acute rheumatic fever
Kawasaki disease
Malignancy
Leukemia
Neuroblastoma
Bone tumor