Knee pain occurs relatively frequently in children. Mostly, harmless growing pains are behind the complaints, which are mainly noticeable at night. During physical exertion, on the other hand, the pain usually does not occur. However, knee problems can also have other causes: severe pain that occurs after a fall during sports, for example, can indicate a knee injury. Likewise, diseases such as Osgood-Schlatter disease or Larsen-Johansson disease are possible in children and adolescents.
Growing pains as a cause
Nearly 20 percent of all children suffer from growing pains from time to time. Children and adolescents between the ages of 4 and 6 and 10 and 16 are primarily affected. The knee pain usually occurs at night and is particularly noticeable in the front of the knees. They often radiate into the upper or lower leg as well. It is typical for growing pains that there are no accompanying symptoms other than the knee pain. It is not yet known what causes growing pains. As a rule, no medical treatment is necessary, as the symptoms subside by themselves over time. Cooling and physical rest can help the knee pain subside more quickly. In rare cases, taking a painkiller can also be useful. Seek advice on this from a doctor or pharmacist. Even if growing pains do not need to be treated per se, other causes such as rheumatism, tumors and Larsen-Johansson disease or Osgood-Schlatter disease should be ruled out by a doctor. If your child complains of knee pain and the symptoms last longer, you should definitely see a doctor about it.
Damage to the knee as a cause
Knee pain in children who are active in sports can indicate an injury to the knee. Especially if your child has fallen or twisted his or her knee during sports, you should see a doctor if knee pain persists: He or she can rule out an injury to the ligaments or meniscus. Knee pain can also be caused by overuse or joint misalignment: Knock knees and bow legs put a lot of stress on the knees, especially in overweight children. In the long term, osteoarthritis can develop as a result of such a malposition. In addition to joint malalignment, it is also conceivable that the pain is caused by muscular imbalances, such as a shortening of the upper or lower leg muscles.
Rheumatic diseases as a cause
If the knee swells painfully in children without external influence, a joint infection triggered by bacteria or viruses may be the cause (postinfectious arthritis). It usually develops as a result of a previous inflammation. Triggers can be, among others, an infection of the respiratory tract or the gastrointestinal tract, but also a tick bite. Acute joint infections are usually harmless in children and do not cause permanent damage if treated properly. Chronic joint inflammation (juvenile idiopathic arthritis), on the other hand, can cause lasting damage to the knee joint. Exactly what causes juvenile rheumatism is not yet known. What is certain, however, is that the disease is based on a faulty reaction of the immune system. However, the fact that children can already suffer from rheumatism is rarely considered by many doctors. If your child complains of prolonged knee pain, however, you should also consider this possibility.
Larsen-Johansson disease
In Larsen-Johansson disease, severe pain occurs due to an inflammatory reaction of the origin of the patellar tendon. In some circumstances, pieces of bone may detach from the patella and die. It is suspected that the disease is triggered by overuse. Particularly at risk are athletically active, male adolescents who exhibit certain risk factors. These include a hollow back, above-average height and muscular imbalances. By taking it easy on the joint, the symptoms usually subside by themselves over time. However, several months may pass before they are completely gone.
Osgood-Schlatter disease
Osgood-Schlatter disease involves irritation of the upper attachment of the patellar tendon. Similar to Larsen-Johansson disease, this can cause individual pieces of bone to die. Here, too, the trigger is probably overuse of the knee joint.It primarily affects boys between the ages of eleven and twelve. Girls are affected much less frequently and at a slightly older age. The pain in the knee occurs primarily during exertion, for example when kneeling as well as when stretching the leg. Typically, there is also a smaller elevation at the top of the tibia, just below the kneecap. The condition usually heals on its own with a break from sports and avoidance of stretching and bending stresses. Again, however, it may take several months before the pain is completely gone.
Osteochondrosis dissecans
Similar to Osgood-Schlatter disease, osteochondrosis dissecans occurs more often in adolescent males. The knee pain results from a piece of cartilage bone dying and subsequently detaching. As a free joint body – also known as a joint mouse – the piece of cartilage can block the knee joint. Typical symptoms of osteochondrosis dissecans include pain both at rest and during movement, as well as recurrent swelling. While mild forms can be treated conservatively, more severe cases require surgery.
Radiating hip problems
When children suffer from knee pain, the cause does not always have to be in the knee. For example, the pain can also radiate from the hip into the knee, as is the case with Perthes disease, a pediatric orthopedic condition. Perthes disease primarily affects boys between the ages of five and nine, but it can also occur earlier or later. It is currently unclear what triggers the disease. In the course of the disease, blood circulation is disturbed and bone tissue in the hip area dies off. As a result, not only does knee pain occur, but the mobility of the hip decreases and a limp develops. Both conservative and surgical therapy aim to relieve pressure on the hip joint.
