Musculoskeletal Key

A Ossification of proximal femur This sequence shows ossification in the normal child. Redrawn from Tönnis (1984). Growth of the upper femur occurs not only in the capital epiphysis and…

A Fetal foot development The limb bud appears by about 4 weeks of gestation and the foot is well formed by about 7 weeks. B Foot growth Dimeglio charts show…

A Congenital anomalies Limb deficiencies (yellow arrow) and Poland anomaly (absence of the sternal head of the pectoralis – red arrow) are caused by a failure of vascular ingrowth during…

A Mild truncal asymmetry These mild asymmetries are variations of normal, do not require treatment, and cause no disability. Normal Development The axial system develops during the embryonic period. Embryo…

A Diagnosis Evaluation requires integration of clinical, imaging, and laboratory findings. Establishing Rapport The goal is to reduce the fear in the child and establish confidence with the parents and…

A Sports participation a priority Even in densely populated areas, providing room for sports is an important community priority (Hong Kong). Sport participation has positive and some negative aspects. The…

A Hyperextension deformities of the knee The boy’s knees hyperextend due to generalized joint laxity. The girl’s have a hyperextension deformity due to a knee injury with loss of knee…

A Infection causes systemic illness This infant has septic arthritis of the elbow and is systemically ill. The prevalence of osteomyelitis is declining and changing character. Long-bone infections caused by…

A Common developmental variations This girl (left) has femoral antetorsion and this boy (above) has physiologic genu valgum. Lower Limb Development Lower limb development shows a wide range of normal…

A Trauma is part of a child’s life This boy sustained a fracture of his forearm and ankle during play. Children’s injuries not only differ from those of adults, they…