Fibromyalgia

Synonyms of Fibromyalgia syndrome

Fibromyalgia belongs to the ub common, idiopathic musculoskeletal pain syndrome, group.

What?

Fibromyalgia is a disease characterized by long-term diffuse musculoskeletal pain, delicate spots in the soft tissues (eyebrow and tendon) and severe fatigue.

How often?

Fibromyalgia occurs especially in adults. The disease is rarely reported in children, especially in adolescence. Girls are affected more often than boys. Children with this disease share many features with children with idiopathic eyebrows and skeletal pain syndrome.

What are typical clinical features?

Patients complain of extensive pain in the tissues. The severity of pain is variable. The pain can be in both parts of the body, in the upper and lower extremities. Sleep is inadequate, and the patient states that in the mornings he is getting out of a hearty, poor quality sleep, and he feels tired even for some time.
Another major complaint is severe fatigue that limits physical capacity.
Patients often complain of headache, feeling of swelling in the arms and legs (although there is no) and numbness.
These symptoms cause anxiety, depression, and too many school absences.

How is it diagnosed?

Diagnosis is made by diffuse pain in four body areas lasting more than 3 months and physical pain in 11 of 18 sensitive points. The painful spots are evaluated by thumb pressure, which can be as reliable as dolorimeter, a sensitive instrument for measuring pain in the clinic.

How is the treatment done?

First of all, it should be explained to the patient and the family that although the pain is severe and real, these pains will not cause any physical harm to the patient, it will not cause any future injury and the pains caused by the pain should be decreased. The treatment is carried out by a team approach of physicians from different specialties and has three main pillars. The most important thing is to start an intensive and continuous exercise program. Swimming exercises are the best in this sense. The second important approach is psychological treatment. It includes individual or group thinking, behavioral psychotherapy methods. The third approach is medication. In particular, some patients may be prescribed medication to regulate the patient's sleep and reduce pain. The use of special cushions that provide neck support during sleep can help.

Result

Without the patient's own effort and the support of his family, the disease is not easy to recover. Generally, the outcome in children is much better than in adults and most people have complete recovery. Adhering to a regular physical exercise program plays the most important role in healing.

Regional idiopathic eyebrow-skeletal pain syndrome: Synonyms:
Reflex sympathetic dystrophy, complex regional pain syndrome type

What?

Extremely severe arm, leg pain with unknown skin changes.

How often?

There is no reliable data on its elegance. However, it is known that adolescents (mean age of onset is around 12 years) and more frequent in girls.

What are the main symptoms?

Generally, there is a long-term and very severe arm, leg pain history that does not respond to treatments and increases over time. It often results in the inability to use the affected arm and leg. In most people called allodynia, painless sensation (mild touch) results in severe pain in these patients.

The coexistence of these complaints creates problems in daily activities of children and often causes too many school absences. In some children, skin color (pale and purple pale appearance), temperature (usually low) and sweating changes occur. Sometimes the child refuses to move his arm or leg in an improper posture and over time, there may be movement limitations due to not using it in that area.

How is the diagnosis made?

Until a few years ago, these syndromes were named with different names, but nowadays most of them are unknown and they are placed under the same umbrella considering that their treatment is the same and they are called regional eyebrow-skeletal pain syndromes. A number of criteria are used for the diagnosis of the disease.
The diagnosis is clinical and depends on the characteristics of the pain (severe, long-term, activity limiting, non-response to treatment, presence of allodynia) and physical examination. The common results of complaints and clinical findings are quite characteristic. Diagnosis is usually made by exclusion of other diseases, and most of the time, differential diagnosis is made until the patient comes to the child rheumatologist. Laboratory findings are normal.

How is the treatment done?

The most useful approach is the initiation of a progressive physical exercise therapy program under the supervision of a physiotherapist; psychotherapy can also be useful. Treatment requires patience in terms of both the child and the family and the treating team. Psychological interventions are usually required because of stress caused by the disease. Many different treatment options (anti-depressants, biological feedback methods, TENS, behavioral therapies) have been proposed, alone or together, without definitive results.

Result

This disease is better for children than adults. Almost all children eventually recover.

Daily life

The child should be encouraged to go to school regularly to establish a normal activity level by contacting with his peers.

Erythromelalgia

Also known as Erythema. The name of the disease comes from the ancient Greek 3 words with distinct meanings: erythrocyte (red), melos (limb), algos (pain). It is very rare but may be common in some families. Most children are 10 years old when they show their symptoms. It's more common in girls. The disease is characterized by a burning sensation in warm, red, swollen feet or rarely on the hands. Symptoms worsen by exposure to heat and relax by cooling the limbs. Therefore, some children refuse to pull their feet out of icy water. The course of the disease is variable.

Avoiding heat and heavy exercise seems to be the most useful treatment approach. In adults, the response to nonsteroidal anti-inflammatory drugs, which has been shown to be beneficial, is generally poor in children. Vein expanders may work.

Growth pains

What?

Growth pains are a benign syndrome that usually expresses the characteristic form of pain in the arms and legs that occur in children younger than 10 years.

How often?

Pain in the arms and legs is the most important reason for pediatride specialist care. Among them, growth pains are the most common. 10-20% of children on the surface of the world is suffering from growth pain and is mostly seen between the ages of 3-12. It is similar in both boys and girls.

What are the main symptoms?

Pain is usually in the legs (skin, calf, knee, back or thigh) and is usually bilateral. Pain often occurs in the evening or at night and often arouses the child. Parents commonly reported that their child developed pain after increased physical activity. The duration of the pain usually lasts 10-30 minutes, but varies between minutes and hours. The severity of the pain may be mild or severe. Growth pain is an intermittent pain with painless periods that last for days and months. In some cases, pain may occur every day.

How is the diagnosis made?

The presence of characteristic pain findings with normal physical examination leads us to the diagnosis. laboratory tests or X-rays are not required; they are all normal.

What are the treatment options?

Explaining that the incident is good-natured may reduce anxiety in the child and the family. Massaging the area during pain attacks and mild painkillers can help. In children with frequent attacks, a dose of ibuprofen may reduce or even prevent pain in the evening.

Result

Growth pains are not associated with any organic disease and usually recovers in late childhood. In 100% of children the pain is lost when they grow.

Benign hypermobility syndrome

What?

Benign hypermobility syndrome (BHS) is a pain in the joints due to increased elasticity of the joints without congenital or connective tissue disease (range of motion). Therefore, BHS is a normal finding rather than a disease.

What are the main symptoms?

Hypermobility often causes knee, ankle and ankle, end of day or night, intermittent, deep and recurrent pain. Piano, cello etc. children who are playing are more affected by fingers. Physical activity and exercise trigger or exacerbate pain. Rarely can be mild joint swelling.

How is the diagnosis made?

It is placed according to the criteria prepared to define joint hypermobility.

How is the treatment done?

Treatment is rarely necessary. If the child is doing some challenging sports such as football or gymnastics, and continuous joint injury / rupture develops, eyebrow strengthening and joint protection (knee pad, etc.) are required.

Daily life

Hypermobility is a benign condition that decreases with age. Families should be aware that the main risk is to prevent children from maintaining their normal lives.
Children should be encouraged to maintain a normal level of activity, including doing the sports they are interested in.

Transient synovitis

Toxic synovitis, irritable hip

What?

It is an unknown cause of hip joint and fluid recovery without any damage.

How often?

It is the most common cause of hip pain in childhood. It affects 2-3% of children aged 3-10 years. It is more common in males (1 to 3-4 females).

What are the main symptoms?

Hip pain and limp. Hip pain may occur as a result of sudden onset of pain in the spoon, upper thigh, or string. The most common picture is the child's limp when he wakes up or refuses to walk.

How is it diagnosed?

Physical examination is limp along with restricted and painful hip movement. In 5% of cases, both hips are kept. X-rays are normal.

How is the treatment done?

The basis of treatment is resting proportional to the degree of pain. Non steroid antiinflammatory drugs are useful in reducing pain. Very severe attacks are applied to the leg traction. The disease usually heals in 6-8 days without treatment.

Result

More than 99% of children will have complete recovery. The development of new transient synovitis episodes is not uncommon, but is usually lighter and shorter.

Patellofemoral pain-knee pain

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Patellofemoral pain is the most common childhood overuse syndrome. This group of diseases is caused by repeated movements or by a continuous exercise-related injury of a particular area of ​​the body. These diseases are more common in adults than in children (tennis player or golfer's elbow, carpal tunnel syndrome, etc.).

Synonyms

Patellofemoral syndrome, chondromalacia, chondromalacia, knee pain.

What?

Patellofemoral pain refers to the ten knee pain caused by patellofemoral insertion (the joint formed between the knee cap and the lower three of the thigh bone). If the pain, the patellar inward-facing surface tissue changes with the chondromalacia of the patella or chondromalasis patella term is used.

How often?

It is very rare in children under eight years of age; In adolescence, it becomes more frequent. Patellofemoral pain is more common in girls. It is more common in children with pronounced angulation, such as X-leg (genu valgum) or O-leg (genu varum) in their knees, and in those with patella disease (recurrent slackness and distortion).

What are the main symptoms?

There are ten knee pain that worsen by activities such as running, climbing stairs, jumping and squatting. The pain may also deteriorate after prolonged sitting where the index remains bent.

How is the diagnosis made?

Patellofemoral pain is a clinical diagnosis in a healthy child (laboratory tests or techniques of view are unnecessary). Pain can be created by pressing on the knee cap or by preventing the patella from moving up when the thigh (quadriceps) is contracted.

How is the treatment done?

It is often unnecessary for children without the disease (indexing disorders or patellar laxity). It is a benign condition that heals spontaneously. It may be useful to start a quadriceps strengthening program if the pain prevents sports or daily activities. Ice relieves pain after exercise.

Daily life

Children should lead a normal life. The amount of physical activity should be adjusted as not to cause pain. Children who are very active in sports can use a knee brace or band.

Slipped femoral head epiphysis

What?

For an unknown reason, the femur is separated from the growth plate. The growth plate is a cartilage segment trapped between the bone tissue. It is the weakest part of the bone and when it is mineralized and completely transformed into bone, bone growth stops.

How often?

It is a rare disease that affects 3-10 children in one hundred thousand children. It is more common in adolescents and boys. Obesity is known as a predisposing factor.

What are the main symptoms?

Decreases in physical activity and worsening limp and leg pain and hip motility. Pain is felt in the upper 2/3 or lower 1/3 of the thigh and increases with motion. In 15% of the children, the disease keeps both hips.

How is it diagnosed?

On physical examination, decreased joint mobility is characteristic. Diagnosis is confirmed by axial plan or x-ray films taken in the frog position.

How is the treatment done?

Surgical nailing: The femoral press is kept in place by placing the nails in place.

Result

The time before the diagnosis differs depending on the degree of sliding of the femur.

Osteochondrosis (synovial osteonecrosis, avascular necrosis)

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The word tir osteochondrosis ste means ”bone death“. It is a group of unknown disease, characterized by the cessation of blood flow to the primary or secondary ossification centers of the affected bones. At birth, the bone is a soft tissue made from more cartilage, which is then mineralized and transformed into a more durable bone. This transformation begins in specific regions, called ossification centers in each bone, and over time it spreads to other parts of the bone.

What?

Osteochondrosis refers to a process associated with the loss of blood supplying the ossification center of the bones and the retraction of this center by the restorative bone tissue. The main complaint of these disorders is pain. The diagnosis is confirmed by imaging methods. In the X-ray, sequential fragmentation (mas islets oss in the bone), collapse (fracture), sclerosis (increased density, ler more whiter kırılma appearance in bone films) and often with rebuilding of the bone contours can be seen. Although it may awaken a serious disease, it is very common in children and in cases where there is no widespread involvement of the hip joint, the disease results very well. Some types of osteochondrosis are so common that they are considered normal variations of bone development (Sever's disease). Others are grouped under extreme use syndromes (Osgood-Schlatter, Sinding-Larsen-Johanson disease).

Legg-Calve- Perthes disease

What?

The femur is the avascular necrosis of the press (which is the closest part of the thigh bone to the hip).

How often?

It is a rare disease seen in 1 in 10000 children. Between 3-12 years of age, it is more common in men (4-5 girls per girl). It is especially common in children aged 4-9 years.

What are the main symptoms?

Most children have limping and varying degrees of hip pain; sometimes there is no pain at all. In general, a single hip is kept, but in about 10% of cases, both are affected.

How is it diagnosed?

The mobility of the hip joint is impaired and may be painful. X-rays may initially be normal, but may then show progress in the introduction. Bone scans and magnetic resonance (MRI) examinations can provide for the detection of disease earlier than plain radiographs.

How is the treatment done?

Children with Legg-calve pertes should always be sent to a pediatric orthopedics department. Treatment depends on the severity of the disease. In very mild cases, observation may be sufficient. In more severe cases, the treatment aims to retain the affected femur press within the hip joint, so that when the new bone formation begins, the femoral head can take its normal spherical shape. This goal can be achieved to some extent by dressing the abduction receiver (in young children) or resecting the femur surgically (osteotomy, cutting the bone from the bone to keep the head better, in older children).

Result

The improvement of the disease depends on the extent to which the femur press is held and also the age of the child. If the incidence is small and the child is less than 6 years, the recovery will be more. It takes 12 )18 months to complete the whole process (from fragmentation to regeneration). Approximately two-thirds of the held hip joints have long-term radiographic results.

Daily life

It depends on the treatment applied. Heavy burden should be avoided in the hip joint of children under observation (jumping and running). However, they should continue their normal school life and participate in all activities that will not carry heavy loads.

Osgood-Schlatter disease

It occurs as a result of repetitive trauma by the patellar tendon to the center of the ossification of the tibial tubercle (a small bone protrusion below the knee). It occurs in about 1 percent of adolescents, more frequently in sports.
The pain increases with movements such as kosma, jumping, climbing stairs and kneeling. Diagnosis is made by physical examination; where the patellar tendon attaches to the tibia, there is sometimes a very characteristic tenderness or pain associated with swelling. X-rays can be normal or small bone fractures can be seen in the tibial tubercle region. Treatment is based on restriction of activity to keep the patient in painless condition, application of ice after sport and rest. It improves over time.

Sever disease

Also known as bilinir calcaneal epiphysis “. It is probably osteochondrosis of the calcaneal apophysis (heel bone) due to the pull of the original tendon.
It is one of the most common causes of heel pain in childhood. Sever's disease depends on activity and is more common in men. Heel pain and limping can be seen after exercise and the age of onset is between 6-10 years of age. Diagnosis is made by clinical examination. There is no need for treatment The activity level should be adjusted to keep the children away from the pain, and if not, use a heel pad. It improves over time.

Freiberg disease

The second metatarsal bone of the foot is osteonecrosis of the press. The cause is probably traumatic. It is not frequent and most of the cases are adolescent girls. Pain increases with activity. On physical examination, tenderness under the second metatarsal bone and rarely swelling is seen. The diagnosis can be confirmed by X-rays, although two weeks may elapse from the onset of symptoms to the appearance of changes. Treatment is done with rest and metatarsal cushion.

Scheuermann's disease

Scheuermann's disease or indeki juvenile kyphosis ya is the osteonecrosis of the ring-shaped apophysis of the life object. It is more common in adolescent men. Most children have postural disorders; back pain may or may not. Pain depends on activity and decreases with rest. The diagnosis is suspected by examination (sharp angulation on the back, hunchback) and confirmed by x-ray. In the case of Scheuermann's disease, the child should have irregularities in his life plates and 5 degrees of caustic forwards at least 3 consecutive periods. Scheuermann's disease generally does not require treatment other than the adjustment of the activity level of the child, observation and gypsum in severe cases