Epidemiology of musculoskeletal pain in a pediatric emergency department
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Published on: February 9, 2011
Jaime de Inocencio1, Miguel Ángel Carro2, Marta Flores2
1Pediatric Rheumatology Unit, Hospital Universitario 12 de Octubre and Universidad Complutense de Madrid, Avda/Córdoba s/n, 28041, Madrid, Spain. jaime.inocencio@salud.madrid.org.
Insights
Musculoskeletal pain (MSP) accounts for 18.2% of pediatric emergency department visits. Trauma, including contusions, fractures, and sprains, is the primary cause, with wrist, ankle, and finger pain being most common.
Area of Science:
- Pediatric Emergency Medicine
- Orthopedics
- Public Health
Background:
- Musculoskeletal pain (MSP) is a common reason for pediatric emergency department (ED) visits.
- Understanding the epidemiology and etiology of pediatric MSP is crucial for effective healthcare planning and injury prevention.
Purpose of the Study:
- To determine the percentage of pediatric ED visits attributed to MSP.
- To identify the most frequent presenting complaints and their locations.
- To characterize the primary etiologies of pediatric MSP.
Main Methods:
- A 1-year cross-sectional study was conducted at a tertiary hospital's ED.
- Demographic and clinical data were collected from children aged 3-14 years presenting with MSP.
- Study days were selected via computer-generated simple random sampling, with data reviewed over 5 days each month.
Main Results:
- Musculoskeletal pain (MSP) constituted 18.2% of all pediatric ED visits.
- The most common complaints were pain in the wrist (19%), ankle (19%), and finger (15%).
- Trauma was the leading etiology (88.4%), encompassing contusions (38%), fractures (21%), and sprains (18%).
- ED visits for MSP increased with age, and fractures were more prevalent in boys.
Conclusions:
- Musculoskeletal pain (MSP) represents a significant proportion of pediatric emergency department visits.
- Trauma is the predominant cause, with specific joint locations and fracture patterns observed.
- Age-related trends and gender differences in fracture prevalence highlight the need for targeted prevention strategies.
Abstract:
The objectives of this study were (1) to determine the percentage of emergency department (ED) visits due to musculoskeletal pain (MSP) by children 3-14 years of age during a period of 1 year; (2) to determine the most frequent presenting complaints; and (3) to characterize their etiology. A cross-sectional study was performed on children aged 3-14(11/12) years attended at the ED of a tertiary hospital due to MSP. The demographic and clinical characteristics of the patients were reviewed 5 days each month for 12 consecutive months. Study days were selected by computer-generated simple random sampling. Out of 4,531 visits to the ED, 826 were due to MSP (18.2 %; 95 % CI 17.1-19.4 %). When compared with children with no skeletal complaints, children with MSP had a similar sex distribution but were older (mean ± SD 7 ± 3.5 years vs 9.9 ± 3.1 years; p < 0.0001). The most common complaints were pain at the wrist (19 %), ankle (19 %) and finger (15 %). The most common etiology was trauma (88.4 %), including contusions (38 %), fractures (21 %) and sprains (18 %). Children with hip (6.7 ± 3 years; p < 0.0001) and elbow (7.8 ± 3.5 years; p < 0.0001) complaints were younger than children with pain in other locations, whereas children with wrist pain (10.5 ± 2.6 years; p < 0.002) and joint sprains (10.7 ± 2.7 years; p < 0.0001) were older. Fractures were more frequent in boys (64 vs 36 %, p = 0.008; OR 1.6; CI 1.1-2.2). Visits to the ED due to MSP increased with age. Pain at three locations represented 50 % of the presenting complaints. Trauma was the principal etiology, but fractures only represented one-fifth of the total.
