Imaging of muscle disorders in children.

Muscle inflammation is a relatively common pathological process in childhood. The diagnosis of the underlying cause relies on an appreciation of the pattern of clinical features, as well as the results of biochemical, histological and radiological investigations. Often the clinical and biochemical features are non-specific and insensitive. Consequently, the radiological abnormalities are very important in establishing a diagnosis and an understanding of the imaging features of muscle inflammatory disorders in childhood is needed. Some of the imaging protocols needed to investigate a variety of muscle and soft-tissue inflammatory conditions in childhood are reviewed in this article. Those features that are helpful in narrowing the differential diagnosis are indicated and a logical approach to the investigation of affected children is provided. The value of MR imaging is highlighted.

Principles of management of musculoskeletal conditions in children and young people.

Musculoskeletal symptoms and rheumatic conditions are common throughout childhood and adolescence. Age- and development-appropriate care and management of children and young people with such conditions is vital, acknowledging that they are NOT small adults! The major aspect of both paediatric and adolescent rheumatology care which differentiates it from adult care is the fact that children and young people are still growing, in contrast to the ageing and senescence which characterizes adult rheumatology. Growth must be considered in the global sense, incorporating cognitive and psychosocial growth as well as physical growth. Likewise, the reciprocal influences of growth and a chronic rheumatic condition should be considered when caring for young people with childhood-onset rheumatic disease. This chapter will detail the general principles of management of such symptomatology with primary reference to chronic conditions.