%0 Journal Article
%T Review for the generalist: evaluation of pediatric foot and ankle pain
%A Kristin M Houghton
%J Pediatric Rheumatology
%D 2008
%I BioMed Central
%R 10.1186/1546-0096-6-6
%X Foot and ankle problems are common in the pediatric population. Problems can be related to skeletal maturity and are fairly specific to the age of the child. An awareness of congenital anomalies, developmental variation, skeletal maturation and lower extremity alignment will aid the physician in evaluation and management. This article will review common causes of foot and ankle pain in the pediatric population. It is not meant to be an exhaustive review and will not review acute traumatic fractures.Most foot and ankle pain in the active pediatric population are associated with minor trauma or repetitive stress combined with abnormal biomechanics of the foot and lower extremity. Older children may isolate pain to a specific site whereas toddlers are more likely limp or refuse to bear weight. Often there is no clear history of traumatic event. There are numerous, non-traumatic diseases that masquerade as injuries.The clinical history should include a thorough description of the pain characteristics (location, character, onset, duration, change with activity or rest, aggravating and alleviating factors, night pain); trauma (acute macrotrauma, repetitive microtrauma, recent/remote); mechanical symptoms (locking, catching, clicking, instability, worse during or after activity); inflammatory symptoms (morning stiffness, swelling); neurological symptoms (weakness, altered sensation); gait (limp, altered weight bearing); effects of previous treatments and the current level of function of the child. Location of pain is the most important historical factor in aiding diagnosis.A history of previous injury and/or surgery, neurological disorder, chronic inflammatory joint disease or bleeding diathesis is significant. Family history of orthopedic, neurologic or rheumatic disease is also important.The basic anatomy of the foot and ankle is shown in Figure 1. Foot and ankle pain can be localized to the forefoot, midfoot, hindfoot or ankle. The forefoot includes the metatarsals, pha
%U http://www.ped-rheum.com/content/6/1/6