Musculoskeletal examination for children and adolescents: do standard textbooks contain enough information?

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Abstract
Sir, Musculoskeletal problems are common presenting symptoms in children and adolescents. They are usually of self-limiting origin but can be a presenting feature of severe, even life-threatening illness (e.g. leukaemia). Patients may present in varied guises to primary or secondary care (including paediatrics, orthopaedics, rheumatology and accident and emergency departments). Symptoms may not be volunteered and a competent musculoskeletal examination, coupled with understanding of the age-dependent variation of normal joint appearance, may be the only way to detect important joint abnormalities. It is imperative, therefore, that all clinicians caring for children and adolescents are competent in musculoskeletal assessment, to facilitate prompt diagnosis, early referral to appropriate specialist teams [1] and ultimately to optimize functional outcome.

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