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July 1996, Vol 150, No. 7 >
Article | July 1996

Musculoskeletal Pain Syndromes That Affect Adolescents FREE

Ilona S. Szer, MD
Arch Pediatr Adolesc Med. 1996;150(7):740-747. doi:10.1001/archpedi.1996.02170320086015.
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Musculoskeletal pain is one of the most common pains of adolescence, along with headache and abdominal pain, and arthralgia is the single most common reason for referral to the pediatric rheumatologist.1 Not surprisingly, the pediatric rheumatologist is frequently called to distinguish organic from functional symptoms. During the past decade, the pediatric rheumatology community has been evaluating increasing numbers of adolescents and preadolescents who experience musculoskeletal symptoms presumably as a defense against emotional stress from achievement either in academic work or in sports. To complicate the challenge further, coexistent organic and psychologic disturbance is not rare. Clearly, organic illness does not protect a patient from emotional pain, and it may be most difficult to differentiate nonorganic pain in a patient with a known organic illness. Conversely, adolescents with organic illness may use their disease for secondary gain. Fear of misdiagnosis of physical illness as psychiatric and the notion that all

REFERENCES

1 +
DeNardo BA, Tucker LB, Miller JC, Szer IS, Schaller JG.  Demography of a regional pediatric rheumatology patient population . JRheumatol . 1994;; 21:1553-1561.
2 +
Jacobs JC.  Psychiatric disorders . In: Jacobs JC, ed. Pediatric Rheumatology for the Practitioner . New York, NY: Springer-Verlag NY Inc; 1992;: 196-197.
3 +
Maisami M, Freeman JM.  Conversion reactions in children as body language: a combined child psychiatry/neurology team approach to the management of functional neurologic disorders in children . Pediatrics . 1987;;80:46-52.
4 +
Bernstein BH, Singsen BH, Kent JT, et al.  Reflex neurovascular dystrophy in childhood . J Pediatr . 1978;;93:211-215.
5 +
Sherry DD, McGuire T, Mellins E, et al.  Psychosomatic musculoskeletal pain in childhood: clinical and psychological analyses of 100 children . Pediatrics . 1991;;88:1093-1099.
6 +
Sherry DD, Weisman R.  Psychologic aspects of childhood reflex sympathetic dystrophy . Pediatrics . 1988;;81:572-578.
7 +
Wolfe F, Smythe HA, Yunus MB, et al.  The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee . Arthritis Rheum . 1990;;33:160-171.
8 +
Szer IS.  Arthritis in adolescence . In: Kulig J, ed. Adolescent Medicine: State of the Art Reviews . Philadelphia, Pa: Hanley & Belfus Inc; 1992;;2: 539-545.
9 +
Walco GA, llowite NT.  Cognitive-behavioral intervention for juvenile primary fibromyalgia syndrome . J Rheumatol . 1992;;19:1617-1619.
10 +
Katz BZ, Andiman WA.  Chronic fatigue syndrome: current literature and clinical issues . J Pediatr . 1988;;113:944-947.
11 +
Fukuda K, Straus SE, Hickie I, et al.  The chronic fatigue syndrome: a comprehensive approach to its definition and study . Ann Intern Med . 1994;; 121:953-959.
12 +
Lane TJ, Manu P, Matthews DA.  Depression and somatization in the chronic fatigue syndrome . Am J Med . 1991;;91:335-344.
13 +
Carter BD, Edwards JF, Kronenberger WG, et al.  Case control study of chronic fatigue in pediatric patients . Pediatrics . 1995;;95:179-186.
14 +
Child AH.  Joint hypermobility syndrome: inherited disorder of collagen synthesis . J Rheumatol . 1986;;13:239-242.
15 +
Grahame R, Child A.  A proposed set of diagnostic criteria for the benign joint hypermobility syndrome . Br J Rheumatol . 1992;:31:205.
16 +
Baugher WH, Bradley GJ, Warren RF, Marshall JL.  Injuries of the musculoskeletal system in runners . Contemp Orthop . 1979;;1:46.
17 +
Jacobs JC, Berdon WE, Johnston AD.  HLA-B27-associated spondyloarthritis and enthesopathy in childhood: clinical, pathologic, and radiographic observations in 58 patients . J Pediatr . 1982;;100:521-528.
18 +
Cabral DA, Oen KG, Petty RE.  SEA syndrome revisited: a long term follow-up of children with a syndrome of seronegative enthesopathy and arthropathy . J Rheumatol . 1992;;19:1282-1285.
19 +
Cahill B.  The treatment of juvenile osteochondritis dissecans of the knee . Clin Sports Med . 1985;;4:367.
20 +
Ogden JA, Southwick WO.  Osgood-Schlatter's disease and tibial tuberosity development . Clin Orthop . 1976;;116:180-189.
21 +
Hungerford DS, Lennox DW.  Rehabilitation of the knee in disorders of the patello-femoral joint . Orthop Clin North Am . 1983;;14:397-402.
22 +
Jaffe HL.  Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone . Arch Surg . 1935;;31:709-728.
23 +
Deane PM, Liard G, Siegel DM, Baum J.  The outcome of children referred to a pediatric rheumatology clinic with a positive antinuclear antibody test but without an autoimmune disorder . Pediatrics . 1995;;95:892-895.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
DeNardo BA, Tucker LB, Miller JC, Szer IS, Schaller JG.  Demography of a regional pediatric rheumatology patient population . JRheumatol . 1994;; 21:1553-1561.
2 +
Jacobs JC.  Psychiatric disorders . In: Jacobs JC, ed. Pediatric Rheumatology for the Practitioner . New York, NY: Springer-Verlag NY Inc; 1992;: 196-197.
3 +
Maisami M, Freeman JM.  Conversion reactions in children as body language: a combined child psychiatry/neurology team approach to the management of functional neurologic disorders in children . Pediatrics . 1987;;80:46-52.
4 +
Bernstein BH, Singsen BH, Kent JT, et al.  Reflex neurovascular dystrophy in childhood . J Pediatr . 1978;;93:211-215.
5 +
Sherry DD, McGuire T, Mellins E, et al.  Psychosomatic musculoskeletal pain in childhood: clinical and psychological analyses of 100 children . Pediatrics . 1991;;88:1093-1099.
6 +
Sherry DD, Weisman R.  Psychologic aspects of childhood reflex sympathetic dystrophy . Pediatrics . 1988;;81:572-578.
7 +
Wolfe F, Smythe HA, Yunus MB, et al.  The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee . Arthritis Rheum . 1990;;33:160-171.
8 +
Szer IS.  Arthritis in adolescence . In: Kulig J, ed. Adolescent Medicine: State of the Art Reviews . Philadelphia, Pa: Hanley & Belfus Inc; 1992;;2: 539-545.
9 +
Walco GA, llowite NT.  Cognitive-behavioral intervention for juvenile primary fibromyalgia syndrome . J Rheumatol . 1992;;19:1617-1619.
10 +
Katz BZ, Andiman WA.  Chronic fatigue syndrome: current literature and clinical issues . J Pediatr . 1988;;113:944-947.
11 +
Fukuda K, Straus SE, Hickie I, et al.  The chronic fatigue syndrome: a comprehensive approach to its definition and study . Ann Intern Med . 1994;; 121:953-959.
12 +
Lane TJ, Manu P, Matthews DA.  Depression and somatization in the chronic fatigue syndrome . Am J Med . 1991;;91:335-344.
13 +
Carter BD, Edwards JF, Kronenberger WG, et al.  Case control study of chronic fatigue in pediatric patients . Pediatrics . 1995;;95:179-186.
14 +
Child AH.  Joint hypermobility syndrome: inherited disorder of collagen synthesis . J Rheumatol . 1986;;13:239-242.
15 +
Grahame R, Child A.  A proposed set of diagnostic criteria for the benign joint hypermobility syndrome . Br J Rheumatol . 1992;:31:205.
16 +
Baugher WH, Bradley GJ, Warren RF, Marshall JL.  Injuries of the musculoskeletal system in runners . Contemp Orthop . 1979;;1:46.
17 +
Jacobs JC, Berdon WE, Johnston AD.  HLA-B27-associated spondyloarthritis and enthesopathy in childhood: clinical, pathologic, and radiographic observations in 58 patients . J Pediatr . 1982;;100:521-528.
18 +
Cabral DA, Oen KG, Petty RE.  SEA syndrome revisited: a long term follow-up of children with a syndrome of seronegative enthesopathy and arthropathy . J Rheumatol . 1992;;19:1282-1285.
19 +
Cahill B.  The treatment of juvenile osteochondritis dissecans of the knee . Clin Sports Med . 1985;;4:367.
20 +
Ogden JA, Southwick WO.  Osgood-Schlatter's disease and tibial tuberosity development . Clin Orthop . 1976;;116:180-189.
21 +
Hungerford DS, Lennox DW.  Rehabilitation of the knee in disorders of the patello-femoral joint . Orthop Clin North Am . 1983;;14:397-402.
22 +
Jaffe HL.  Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone . Arch Surg . 1935;;31:709-728.
23 +
Deane PM, Liard G, Siegel DM, Baum J.  The outcome of children referred to a pediatric rheumatology clinic with a positive antinuclear antibody test but without an autoimmune disorder . Pediatrics . 1995;;95:892-895.

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