World Pediatric Bone and Joint Day

World Pediatric Bone and Joint (PB&J) Day highlights important bone and joint-related conditions about which kids, adolescents, and their parents should be aware.

According to Lemak Health's Primary Care Sports Medicine physicians, the most common pediatric musculoskeletal conditions are fractures, growth plate injuries, overuse syndrome, apophyseal pain, and bone infections.


The forearm experiences 40-50% of all childhood fractures. Falling with an outstretched arm can cause a fracture to one or both of the bones (ulna and radius) of the lower arm. “High energy, contact sports place youth at greater risk for forearm fractures,” warns Dr. Sedlis. Most fractures can be treated with casting for a period of time, while more severe cases often require surgical treatment.

Growth Plate Injuries

Growth plates are the weakest seams in a child’s skeleton and are the most susceptible to injury. All growing children have growth plates in their bones and are at risk for growth plate injuries until the soft tissue is eventually replaced with solid bone. Growth plate injuries “can have devastating effects on the overall growth of children.” Any injury or impact, such as twisting an ankle or knee, can cause harm to the growth plate.

“Ligaments surrounding a child’s joint are not very strong and may not be able to fully stabilize a fracture,” Dr. Sedlis adds. Treatment for growth plate injuries depends on several factors such as which bone is injured, the type of fracture, the age of the child, and other associated injuries and circumstances. Injured growth plates should be casted, immobilized, and then rested. If the injury is severe enough, surgical intervention may be needed.

Overuse Syndrome

Overuse syndrome is a widespread pediatric musculoskeletal injury and is caused by too much participation in sports. Little league elbow is an example of overuse syndrome that affects the growth plate on the inside elbow of the throwing arm in a baseball player. Lemak Health warns to be wary of the condition because it “can do serious damage to the growth plate in the arm due to repetitive use and excessive throwing.” This is the reason for strict limits on how many pitches or innings a young pitcher is allowed to throw. Physicians recommend rest coupled with rehabilitation to allow the bones to heal but sometimes surgery is necessary to reattach the growth plate to the bone.

Apophyseal Pain

Apophyseal pain is common in the pediatric population, especially during periods of rapid growth and while youth are very active. The apophysis is the site of tendon attachment prior to skeletal maturity. Dr. Spellmon recommends rest, ice, anti-inflammatories, and rehab to treat apophyseal overuse injuries, and immobilization, rest, and rehab for an avulsion injury. However, with an avulsion fracture, depending on the severity, surgical intervention may be necessary.

Bone Infection

Several different types of bacteria live on the skin and are considered normal skin flora. Dr. Spellmon says “whenever skin is broken, for example when sliding into home base, skin scratched while getting tackled on turf, or even a small cut from roughhousing in the front yard, the barrier is also broken allowing bacteria to enter the bloodstream.” While children are still growing there is an abundant supply of blood to the bone and sometimes bacteria seed in the bone and cause an infection. This bone infection is called osteomyelitis and typically requires a hospital stay with IV antibiotics followed by oral antibiotics. In addition, labs, radiographs, and a clinical exam are typically followed until all are normalized.

Pediatric musculoskeletal injuries, when not diagnosed early and managed appropriately, can result in long-term disabling conditions. They can lead to time away from school and chronic pain and disability later in life. Many of these conditions can be prevented by measures taken to lessen the chance of occurrence. Raising awareness of these conditions in young people may allow them to live healthier lives, free from pain and conditions such as osteoporosis and arthritis that may surface later in life.

If you would like to schedule an appointment with Lemak Health, please call 205-397-5200 or visit