It is important that paediatric orthopaedic surgeons recognise that psychological conditions may present with musculoskeletal symptoms. Identification through careful and sensitive history taking is vital. There is a lack of training in this regard in paediatric orthopaedics. We present a series of cases initially referred for a musculoskeletal complaint. Further probing revealed an underlying psychological problem which was neither picked up by the referring physician nor volunteered by the patient. In our opinion, it is important that this training omission is addressed as such psychological problems may be devastating for these individuals and their families.
KesslerRCAmmingerGPAguilar-GaxiolaSet al.Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry2007; 20: 359–364.
2.
BelferML. Child and adolescent mental disorders: the magnitude of the problem across the globe. J Child Psychol Psychiatry2008; 49: 226–236.
3.
MurrayCLopezA. World health report 2002: reducing risks, promoting healthy life, Geneva, Switzerland: World Health Organization, 2002.
4.
BogartLMElliottMNKleinDJet al.Peer victimization in fifth grade and health in tenth grade. Pediatrics2014; 133: 440–447.
5.
BucchianeriMMEisenbergMEWallMMet al.Multiple types of harassment: associations with emotional well-being and unhealthy behaviors in adolescents. J Adolesc Health2014; 54: 724–729.
6.
JanssensHClaysEDe ClercqBet al.The relation between psychosocial risk factors and cause-specific long-term sickness absence. Eur J Public Health2014; 24: 428–433.
7.
HovenCWDoanTMusaGJet al.Worldwide child and adolescent mental health begins with awareness: a preliminary assessment in nine countries. Int Rev Psychiatry2008; 20: 261–270.
8.
YeoAJamesKRamachandranM. Normal lower limb variants in children. BMJ2015; 350: h3394–h3394.
9.
Staheli LT. Fundamentals of pediatric orthopedics. 4th Rev Ed. US: Lippincott Williams & Wilkins, 2007.
10.
SherryDDMcGuireTMellinsEet al.Psychosomatic musculoskeletal pain in childhood: clinical and psychological analyses of 100 children. Pediatrics1991; 88: 1093–1099.
11.
Kashikar-ZuckSGoldschneiderKRPowersSWet al.Depression and functional disability in chronic pediatric pain. Clin J Pain2001; 17: 341–349.
