Musculoskeletal Issues in Children and Adolescents

This edition of FP Essentials addresses musculoskeletal issues in children and adolescents. FP Essentials topics are selected by the editorial board. We follow a 3-year curriculum to ensure a broad range of topics relevant to family medicine. From each 3-year overview, the editorial board crafts a 12-month slate of editions, each with the four subtopics that become the call for authors and ultimately the editions you read each month.

The editorial board works hard to find a balance between topics we think readers encounter regularly and topics we think might be less common, but still important to know about. This edition of FP Essentials reflects that balance well. Section One covers the newborn examination, a fundamental skill taught universally in residency and practiced on a frequent basis by many family physicians. The conditions and examination maneuvers described in Section One will be familiar to many, and we hope will provide additional context and updates to your current knowledge and understanding. Section Two addresses genetic disorders with musculoskeletal components. Some of these are often seen in family medicine, such as Down syndrome, whereas others are somewhat more rare, such as Marfan syndrome or osteogenesis imperfecta. Patients and families value our expertise with these conditions alongside our specialist colleagues. Section Three, adolescent idiopathic scoliosis, discusses another commonly seen condition and describes the range of management options for various degrees of severity. Section Four likewise covers injuries most family physicians will see, such as fractures and overuse injuries, as well as the presentation, diagnosis, and treatment options for these conditions.

Musculoskeletal conditions are commonly encountered by family physicians when caring for children and adolescents. I hope this edition of FP Essentials builds on a foundation of information you already feel familiar with and brings your attention to some new information.

Kate Rowland, MD, FAAFP, Associate Medical Editor
Vice Chair of Education and Associate Professor,
Department of Family Medicine
Rush University, Chicago, Illinois

Jeffrey C. Leggit, MD, CAQSM, is a professor of Family Medicine, Military and Emergency Medicine, and Physical Medicine and Rehabilitation at the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland. Dr. Leggit is the vice chair for the department and the director of health care operations for the USUHS University Family Health Center. He is the clinical module director for the musculoskeletal curriculum at the USU School of Medicine. In addition, he is one of the key faculty for the National Capital Consortium Military Primary Care Sports Medicine Fellowship. He retired from the Army Medical Corps after 25 years of military service. He has authored more than 50 peer-reviewed articles as well as 14 textbook chapters. He is an active researcher and clinician.

Francis G. O’Connor, MD, MPH, FACSM, FAMSSM, is the medical director of the Consortium for Health and Military Performance and a professor of Military and Emergency Medicine at USUHS. He has been a leader in sports medicine education and research for the military for more than 30 years. He is retired from the US Army. He has authored more than 100 peer-reviewed articles in scientific journals and is the editor of 10 texts on sports medicine, including the Textbook of Running Medicine; Musculoskeletal and Sports Medicine for the Primary Care Practitioner, 4th edition; and ACSM’s Sports Medicine: A Comprehensive Review. He is a past president of the American Medical Society for Sports Medicine (AMSSM).

Julie Creech-Organ, DO, CAQSM, FAAFP, is an assistant professor of Family Medicine at USUHS and core faculty at the Saint Louis University (Southwest Illinois) Family Medicine Residency. As core faculty, she is the director of osteopathic education and the sports medicine and orthopedics curricula director. She completed a sports medicine fellowship. She currently serves as cochair of the AMSSM Certification of Added Qualifications committee.

Jacqueline L. Yurgil, DO, CAQSM, is an assistant professor of Family Medicine at USUHS. She is currently associate program director of the National Capital Consortium Military Primary Care Sports Medicine Fellowship. She completed a primary care sports medicine fellowship. Dr. Yurgil’s clinical interests include female athlete health and military medicine. She is the author of more than 10 publications on topics in musculoskeletal sports medicine.

Disclosure: It is the policy of the AAFP that all individuals in a position to control CME content disclose any relationships with ineligible companies upon nomination/invitation of participation. Disclosure documents are reviewed for potential relevant financial relationships. If relevant financial relationships are identified, mitigation strategies are agreed to prior to confirmation of participation. Only those participants who had no relevant financial relationships or who agreed to an identified mitigation process prior to their participation were involved in this CME activity. All individuals in a position to control content for this activity have indicated they have no relevant financial relationships to disclose.

• Summarize a comprehensive newborn musculoskeletal examination.
• Identify common abnormalities on a newborn musculoskeletal examination.
• Describe common and less common genetic musculoskeletal disorders of childhood.
• Define adolescent idiopathic scoliosis.
• Summarize adolescent idiopathic scoliosis management.
• Discuss common musculoskeletal injuries in children and adolescents.
• Describe management of common musculoskeletal injuries in children and adolescents.