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Slovenska pediatrija 2019; 26: 146-153

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Review article


Tanja Slokar
Oddelek otroške ortopedske kirurgije Ortopedska klinika Univerzitetni klinični center Ljubljana Zaloška cesta 9, 1000 Ljubljana, Slovenija

Tjaša Nanut
Zdravstveni dom Ajdovščina, Ajdovščina, Slovenija

Goran Kotnik Oven
Pediatrična klinika Ljubljana, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

Karin Schara
Oddelek otroške ortopedske kirurgije, Ortopedska klinika, Univerzitetni klinični center Ljubljana, Ljublajana, Slovenija


Lower limb pain is a common complaint in children. It is most often linked to mild injuries which subside within a few days of rest. Serious causes of lower limb pain have to be recognized and treated promptly to lower the inci­dence of complications that can affect normal growth or limb function or can even be life-threatening. It is important to focus on the onset and the type of pain, the child‘s age, eventual family history, comorbidities and other local and systemic signs. Steady night pain that is esca­lating is a red flag as it can be linked to malignancy. Limp­ing and antalgic posture can often be present. Both lower limbs and adjacent joints have to be examined. In primary care x-ray and laboratory blood tests can be performed. Acute injuries are referred to the trauma surgeon. A child with possible septic arthritis or osteomyelitis must be sent to the infectious diseases department after laboratory blood tests are taken. If we suspect a rheumatological disease, we have to refer the child to a rheumatologist. After ruling out other possible etiologies, growing pain can be considered. The orthopaedic surgeon takes care of the children in need of invasive diagnostics and surgical treatment.

Key words: lower limb, pain, child