Howard F M
Frimley Park Hospital, Surrey.
Br J Gen Pract. 1990 Jun;40(335):233-5.
The child that is slow to walk causes concern. When cerebral palsy, mental retardation and muscular dystrophy have been excluded, what remains? Thirty five children (19 boys and 16 girls) with hypermobile joints, blue sclera and bat ears (the 'lax ligament syndrome') were referred by general practitioners to a general paediatric outpatient clinic over two years. Three were referred in the first three months of life because of clicking hips; 14 children aged one to two years, had delayed milestones of motor development and exhibited bottom shuffling; 10 children aged four to five years presented with 'growing pains' or 'funny gait' and eight older children had multiple minor complaints. The lax ligament syndrome is a comparatively common mild collagenopathy. It may well come to light on routine surveillance in general practice. It is dominantly inherited and improves with time; management is therefore expectant and symptomatic. A firm and reassuring diagnosis can be given which saves both anxiety and investigations.
走路迟缓的孩子令人担忧。排除脑瘫、智力迟钝和肌肉萎缩症后，还剩下什么呢？在两年时间里，全科医生将35名关节活动过度、巩膜呈蓝色且耳朵如蝙蝠耳（“韧带松弛综合征”）的儿童（19名男孩和16名女孩）转诊至一家普通儿科门诊。3名在出生后的头三个月因髋关节弹响被转诊；14名1至2岁的儿童运动发育里程碑延迟，表现为臀部拖地挪动；10名4至5岁的儿童出现“生长痛”或“步态异常”，8名年龄较大的儿童有多种轻微不适。韧带松弛综合征是一种相对常见的轻度胶原病。在全科医疗的常规监测中很可能会被发现。它是显性遗传的，会随时间改善；因此管理方式是观察并对症治疗。可以给出明确且令人安心的诊断，从而避免焦虑和不必要的检查。
