Duration of growth pain in the knee

Growth pain in the knee usually occurs at night and lasts for a few minutes to hours. After the administration of painkillers, they can usually improve within 30 minutes so that the affected child can sleep again. In the morning, the pain usually disappears.

During individual growth spurts these pains can occur more frequently. These phases usually last several weeks. Overall, growth pain in the knee can occur throughout the entire growth of the affected child. They usually disappear as soon as the child is fully grown. In girls this is usually the case at around 16 years of age, in boys it can continue until they are 18 or 20.

Diseases to be excluded

Schlatter’s disease is a disease in which irritation of the knee occurs. This irritation occurs exactly at the point where the patella tendon (tendon of the kneecap) is attached to the tibia. The disease occurs particularly in young people who are active in sports, which is why it is very likely that the complaints are caused by overloading of the patellar tendon.

However, the increased incidence of Schlatter’s disease can also be observed during strong growth spurts during puberty. While the pain usually begins in one knee, the other knee is usually affected over time. The irritation of the tendon can also cause small pieces of bone to come loose from the tibial plateau.

These are then no longer supplied with nutrients and die off after some time. If the disease is discovered before major bone defects occur, the prognosis is good. As a rule, a sports break is sufficient as therapy.However, the small pieces of bone that come out of the tibia can also be deposited in the patella tendon and cause problems there time and again.

In this case, these small bony parts should be surgically removed. Schlatter’s disease can usually be diagnosed on the basis of the typical symptoms alone. In order to assess the bony situation, however, an x-ray or MRI is often still useful.

Similar to Schlatter’s disease, Sinding-Larsen’s disease, or more precisely Sinding-Larsen-Johansson’s disease, is due to overloading of the knee. This causes irritation at the point where the patella tendon attaches to the kneecap. As in Schlatter’s disease, the irritation and inflammatory reaction can cause small pieces of bone to be released from the kneecap, which then die off.

This process is called osteo necrosis (osteo = bone, necrosis = death of tissue). Sinding-Larsen’s disease is usually diagnosed solely on the basis of its clinical symptoms. In addition, an ultrasound of the knee can be performed.

There, the tendon structure of the patella tendon can be assessed particularly well. However, X-rays and MRI are also used to assess the bones and surrounding tissue. As with Schlatter’s disease, small pieces of bone can become lodged in the patella tendon, causing permanent pain and should therefore be removed surgically.

Otherwise, adequate therapy with painkillers and cooling of the knee are the measures of choice. In order to get rid of the complaints permanently and to prevent a relapse, it may be necessary to take a break from sports, which can last from a quarter to a whole year. In osteochondrosis dissecans, a small portion of the cartilage plus/minus the bone in the joint becomes loose.

This piece of cartilage can then be found in the joint as a free joint mouse. The cause of this disease is presumably small so-called micro-traumas, which occur, for example, during sports with high stress on the knee. Due to the small traumas, the cartilage is not sufficiently supplied with nutrients and dies.

This process takes place in three phases: First, it begins with the so-called slumber stage, in which the cartilage and possibly the underlying bone are less well supplied. In the second phase, a slightly damaged cartilage layer develops, which already begins with initial detachment processes from the remaining bone. In the third stage, the fragment has separated and forms a free joint body.

The therapy of osteochondrosis dissecans is strongly discussed and depends on age and the severity of the disease. The methods used range from conservative treatment with avoidance of high-impact sports (sports with high stress on the joints) as well as painkillers and physiotherapy, to fixation of the not yet completely detached bone area, to removal of the free joint body. In adults, it may also be considered to implant a bone from the iliac crest with good blood supply to replace the detached bone piece, as this will make the heavily loaded joint surface more even again and cause less consequential damage such as arthrosis.

King’s disease

König’s disease is a special form of osteochondrosis dissecans that occurs in children. Before growth is complete, the bones are not yet completely closed; instead, they have many cartilaginous parts that have a great potential for growth. At the same time, this leads to reduced bone strength before growth is complete.

Therefore, osteochondrosis dissecans can easily occur, in which small pieces of cartilage and bone become detached from the joint surface. In König’s disease, the joint surface of the femur in the knee is affected. König’s disease König’s disease is a special form of osteochondrosis dissecans that occurs in children.

Before growth is complete, the bones are not yet completely closed; instead, they have many cartilaginous parts that have a great potential for growth. At the same time, this leads to reduced bone strength before growth is complete. Therefore, osteochondrosis dissecans can easily occur, in which small pieces of cartilage and bone become detached from the joint surface.

In König’s disease, the joint surface of the femur in the knee is affected. Juvenile arthritis is a rheumatological disease that occurs in childhood and adolescence. In this case, the body attacks its own joints for previously unknown reasons, resulting in chronic inflammation in the affected joints.

The typical symptoms are pain, overheating and swelling of the affected joint. An effusion can also occur in the joint.In order to be diagnosed as juvenile arthritis, the disease must have been present for more than 6 weeks and be present in patients under 16 years of age. The therapy consists of dosed sport and physiotherapy as well as the administration of painkillers and anti-inflammatory drugs.

Reactive arthritis refers to an inflammation of the joints that occurs after a bacterial infection. Typically, the bacterial infection is located in the gastrointestinal tract, the respiratory tract and the lungs and urinary tract. Reactive arthritis usually affects a single joint in the legs, often the knee joint.

Characteristic is the manifestation on only one side. The treatment of reactive arthritis consists of physiotherapy, pain medication and anti-inflammatory drugs. Purulent arthritis develops when a bacterial infection occurs in the joint itself.

The pathogens can enter the joint via the bloodstream or migrate into the joint from adjacent structures such as muscles. A purulent arthritis is also possible after an operation on joints, as bacteria can enter the joint from outside. Typically, pain, swelling, redness and a functional impairment of the joint occur.

Fever is also a possible symptom. The treatment consists of the administration of antibiotics. Perthes disease is a disease of the hip joint, in which bone tissue at the femoral head dies for reasons unknown to date.

The bone necrosis is probably caused by reduced blood flow to the femoral head or a hormonal imbalance. Usually, the disease causes unilateral hip pain. Perthes disease is diagnosed with an X-ray.

Ultrasound of the hip already shows an effusion in the hip joint, which substantiates the suspicion of Perthes disease. Depending on the progress of the disease, physiotherapy and orthoses may be sufficient treatment, in advanced stages surgery is usually necessary. Since the hip and knee form a functional unit when walking, many hip diseases such as M. Perthes in children are initially noticed by knee pain. Additional information here: Perthes disease