All general paediatric problems including:
- abdominal pain,
- skin conditions such as eczema,
- chronic fatigue syndrome,
- chronic pain syndrome
Rheumatological conditions such as:
- leg pains,
- abnormal gait,
- swollen or painful joints,
WHAT IS HYPERMOBILITY SPECTRUM DISORDER?
Hypermobility spectrum Disorder (HSD) is a condition related to flexible or hypermobile joints. Once attributed to ‘growing pains‘ we now know this is not due to growing at all, but rather due to flexibility, with weakness of muscles. Being very flexible is usually an advantage, but in some children, their muscles find it difficult to cope with the flexibility of the joints, and this causes limb pains, abnormal gait such as walking with feet turned inwards, or outwards, or walking on tiptoe. This can cause tiredness and fatigue and some children often want to be carried or pushed in a buggy rather than walking.
Children with this condition often bruise very easily and sometimes scar, particularly with conditions such as chickenpox. Writing difficulties are very common, in particular slow writing, messy writing and difficulty keeping up. Headaches and tummy aches are also commonly associated with it. In adolescence, patients often feel dizzy or faint when they go from sitting or lying to standing up. Backache is quite commonly seen, particularly in adolescence. Some children suffer from sleep disturbance related to this and can fatigue with very little exercise. Management is not with medicines but the input of a team of specialists, including physiotherapy, podiatry, occupational therapy and osteopathy.
WHAT IS JUVENILE ARTHRITIS?
Juvenile Idiopathic Arthritis is the commonest cause of long term arthritis in childhood and is very different to adult rheumatoid arthritis. The commonest form of arthritis we see in children is where a few joints are affected, and aren‘t necessary very painful, but are quite often stiff and swollen, particularly in the mornings.
This is a rare condition affecting only one in a thousand children but it is important that it is detected and treated early before long term problems occur. Less frequently a lot of joints can be affected from the start and this needs more intensive treatment. Inflamed joints are best managed with joint injections usually done under a light general anaesthetic, medicines are also used especially if many joints are inflamed.