Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, London, UK.
Br J Hosp Med (Lond). 2024 Sep 30;85(9):1-13. doi: 10.12968/hmed.2024.0258. Epub 2024 Sep 24.
The prevalence of paediatric knee injuries is increasing due to higher participation in competitive sports, larger build and more use of imaging in diagnosis. A thorough history of injury (including mechanism and symptoms of pain and instability), together with a comprehensive examination (presence of an effusion, tender areas, range of movement and joint laxity) will dictate the need for radiological investigations. Magnetic Resonance Imaging (MRI) is indicated in most paediatric patients with a history of injury and an acute knee effusion, which indicates damage to an intra-articular structure. Red flags requiring onward referral to a specialist include diagnosed fractures, traumatic knee effusion, instability, or persistent unexplained nocturnal pain or lump. Correct identification and management of injuries will help reduce long-term morbidity. The aim of this review is to provide the reader with an understanding of the management of paediatric knee injuries at primary presentation in the community setting or emergency department.
由于儿童参与竞技运动的比例增加、体型更大以及在诊断中更多地使用影像学,儿科膝关节损伤的患病率正在上升。全面的损伤病史(包括损伤机制和疼痛、不稳定的症状),以及全面的体格检查(关节积液、压痛区域、活动范围和关节松弛),将决定是否需要进行影像学检查。对于有损伤史和急性膝关节积液的大多数儿科患者,磁共振成像(MRI)是指征,这表明关节内结构受损。需要转介给专家的危险信号包括确诊的骨折、创伤性膝关节积液、不稳定,或持续不明原因的夜间疼痛或肿块。正确识别和处理损伤将有助于降低长期发病率。本综述的目的是为读者提供在社区环境或急诊科初次就诊时管理儿科膝关节损伤的相关知识。