TABLE OF CONTENTS

 

GENERAL INFORMATION

 

Disclaimer: The statements and opinions contained in the articles of the American College of Osteopathic Pediatricians’ (ACOP) eJournal are solely those of the individual authors and contributors and not necessarily those of the ACOP. The appearance of advertisements in the ACOP eJournal is not a warranty, endorsement or approval of the products or services advertised or their effectiveness, quality or safety. The ACOP disclaims responsibility for any injury and/or damage to persons or property as a matter of products liability, negligence, or otherwise, or from any use of operation or any methods, products, instructions, or ideas contained in the material herein. Discussions, views, and recommendations as to medical procedures, choice of drugs, and drug dosages are the responsibility of the authors.

From the Sidelines Information

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From the Sidelines

A Quarterly Tip to Help with
Common Pediatric Sports Medicine injuries

Pediatric Stress Fractures

John Casey Turner, OMS-IV
VCU Riverside Family Medicine Residency
Newport News, Virginia

Adolescent involvement in competitive athletics has been increasing for some time and with a high level of intensity and competition we are seeing a rise in the incidence of overuse injuries within the pediatric populations. One common injury to look out for is a stress fracture. 

Stress fractures in the pediatric population are commonly caused by repetitive, excessive stress causing microfractures to build up in previously healthy cortical bone. With a sometimes enigmatic history the common picture is for slowly progressing, localized, aching pain; often not associated with any trauma. The most common location for these injuries are in the tibia, but can occur especially in other long bones of the lower extremity and the pars interarticularis of the spine.

What do you do when you suspect this injury? Keep it simple and start with plain radiographs. In severe cases these may reveal a periosteal reaction, and sometimes endosteal thickening. It is important to be suspicious as 90% of plain radiography can be negative in the first few weeks of injury. Sometimes in order to definitively diagnoses these injuries a MRI can assist in the gradation of the injury.

Treatment usually involves rest and exclusion from training and competition.  In difficult and high-risk cases consultation with a sports medicine or orthopedic specialist should be considered.

Works Referenced:

Davis, Kirkland W, Imaging Pediatric Sports Injuries: Lower Extremity. Radiologic Clinics of North America. 2010 Nov;48(6):1213-35

Patel, Dilip, Stress Fractures: Diagnosis and Management in the Primary Care Setting. Pediatric Clinics of North America. 2010 Jun;57(3):819-27

John Casey Turner is a fourth year medical student at the Edward Via College of Osteopathic Medicine (VCOM) who hopes to do a residency in Emergency Medicine.

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Dr. Smith is a second year Family Medicine Resident at the VCU Riverside Family Medicine Residency in Newport News, Virginia. He plans on doing a fellowship in Primary Care Sports Medicine.