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Fatigue and pain in children with multiple osteochondromas: a cross-sectional study
Ihsane Amajjar1,2, Nienke W Willigenburg3, Rob J E M Smeets4,5
1Department of Rehabilitation Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands. i.amajjar@maastrichtuniversity.nl.
Insights
Children with multiple osteochondromas (MO) experience significantly higher fatigue and pain levels compared to healthy peers. Psychosocial factors are strongly linked to these symptoms, highlighting the need for comprehensive care.
Area of Science:
- Pediatric Orthopedics
- Clinical Psychology
- Rehabilitation Medicine
Background:
- Multiple osteochondromas (MO) is a rare genetic disorder causing multiple benign bone tumors.
- While pain and fatigue are common in MO, their impact on children is understudied.
- This research addresses the need to quantify fatigue and pain in pediatric MO patients.
Purpose of the Study:
- To assess fatigue and pain levels in children diagnosed with MO.
- To compare the severity of fatigue in children with MO against healthy controls.
- To identify factors associated with fatigue and pain in this population.
Main Methods:
- A cross-sectional study involving 134 children (aged 4-18) with MO.
- Validated online questionnaires assessed fatigue (CIS, VAS-fatigue), pain (VAS), and psychosocial factors.
- One-sample t-tests compared fatigue scores to healthy peers; regression analyses identified associated variables.
Main Results:
- 89.6% of children with MO reported fatigue (VAS-fatigue=3.17±2.63), with significantly higher CIS scores than controls (66.32±24.63 vs. 55.07±20.99, p=0.012).
- 75.4% reported pain (VAS=2.41±2.42).
- Fatigue (CIS, VAS-fatigue) and pain were associated with psychosocial factors, including emotional/behavioral problems and depressive symptoms. Pain was linked to functional disability.
Conclusions:
- Fatigue and pain are highly prevalent and more severe in children with MO compared to healthy children.
- Psychosocial factors significantly correlate with both fatigue and pain experiences.
- Multidisciplinary management approaches are crucial for addressing the complex needs of children with MO.
Background:
Multiple osteochondromas (MO) is a rare, inherited disorder characterized by multiple benign bone tumors. Although pain and fatigue are commonly encountered in clinical practice, their impact on children with MO remains largely unaddressed in literature. This study aimed to (1) assess fatigue and pain levels in children with MO, (2) compare fatigue severity with healthy peers, and (3) identify variables associated with fatigue and pain.
Methods:
In this cross-sectional study, 230 children (4-18yrs.) with MO were invited to complete validated, age-specific online questionnaires addressing fatigue (Checklist Individual Strength [CIS], visual analogue scale [VAS-fatigue]), pain (VAS), and psychosocial factors. Fatigue scores were compared to reference data from healthy peers using one-sample t-tests. The International Classification of Functioning, disability and health framework was used for a-priori selection of potential independent variables for multivariable regression analysis.
Results:
A total of 134 children participated. Fatigue was reported by 89.6% (VAS-fatigue = 3.17 ± 2.63), with CIS scores significantly higher than healthy controls (CIS-MO = 66.32 ± 24.63 vs. CIS-healthy peers = 55.07 ± 20.99, p = 0.012). Pain was reported by 75.4% (VAS = 2.41 ± 2.42). For fatigue, both CIS and VAS-fatigue were associated with pain and emotional/behavioral problems (CIS-model adj. R2 = 0.524, p < 0.001; VAS-fatigue model adj. R2 = 0.576, p < 0.001). CIS was also associated with depressive symptoms (CDI, p = 0.019). The pain regression model explained 45% of the variance (p < 0.001), and pain was significantly associated with functional disability and VAS-fatigue (p < 0.001).
Conclusion:
Fatigue, alongside pain, is highly prevalent and significantly increased in children with MO compared to healthy peers. Psychosocial factors are closely associated with both fatigue and pain, underscoring the importance of multidisciplinary disease management.
Clinical Trial Number:
Not applicable.
