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Paediatric and adolescent rheumatology

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G/WEDS/RHE1 IS THERE A DIFFERENCE IN THE MAGNITUDE OF THE FEMORAL NECK ANTEVERSION ANGLE BETWEEN THOSE 2–10-YEAR OLD CHILDREN WHO MANIFEST THE CLINICAL SIGNS OF “GROWING PAINS” AND THOSE THAT DO NOT? A BLINDED, CROSS-SECTIONAL PILOT STUDY

J. Leighton.University of Portsmouth, Portsmouth, UK

Aims: “Growing pains” (GP) has been associated with reduced tibial speed of sound (SOS), more tender points and reduced pain thresholds; however, its aetiology remains unknown. Femoral neck anteversion angle (FNA) has been implicated with several paediatric orthopaedic complaints. Normal FNA regression occurs from birth to mid-adolescence from 36° down to 11–15° through progressive internal torsion of the femoral neck relative to the diaphysis. This blinded, cross-sectional pilot study investigates relative difference in mean FNA between children (aged 2–10-year old) with/without GP symptoms and for within-group correlations between age and FNA.

Methods: Healthy subjects aged 2–10 years old, whose parents gave written consent and who met inclusion criteria, were consecutively recruited from two infants schools and a nursery; their parents completed a validated leg pains questionnaire used to systematically score and categorise subjects into control or test groups based on a widely accepted definition. Subjects were clinically evaluated for: FNA and hip internal/external rotation (IHR/EHR) by a chiropractor blinded to group designation. The study was terminated when 100 subjects had been examined, including at least 20 “with-GP” designates. Examination data were concealed from the investigator during data analysis and scoring of questionnaire responses. Ethics committee approval was given.

Results: Of 123 children with parental consent, 111 met criteria and all 111 questionnaires were returned. The study was terminated with 100 examined subjects; questionnaire scoring designated n = 33 to test group, n = 67 to controls. High-side (control 54±9° (95% CI 51–56); test 62±12° (95% CI 58–67), p<0.0001) and absolute difference IHR (control 9±11° (95% CI 6–12); test 19±14° (95% CI 14–24), p = 0.0002) were significantly different between groups. High-side (control 30±8° (95% CI 28–32); test 37±8° (95% CI 34–39), p = 0.0003) and absolute difference FNA (control 5±6° (95% CI 4–7); test 13±8° (95% CI 10–15), p<0.001) were significantly …

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