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Neck pain in children 儿童颈部疼痛
Q3 Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-23 DOI: 10.1016/j.paed.2025.12.004
Susan Gorman, Laura Duthie
Neck pain is a common presentation to healthcare services. However, in childhood it can present in a variety of ways depending on the underlying cause and age of the child. It can easily be overlooked, especially in younger children who may not be able verbalize what the problem is. Although clinicians often feel more comfortable in the assessment of neck pain that occurs secondary to trauma, a significant proportion of children will have a medical cause. Many cases of neck pain are self-resolving, but a proportion of children will require further investigation or urgent onward referral based on important and significant clinical findings obtained when assessing the child. This article aims to give an overview of the approach to both traumatic and atraumatic neck pain. It discusses the important features point towards a more significant underlying cause, and the most appropriate investigations to perform.
颈部疼痛是医疗保健服务的常见表现。然而,在儿童时期,它可以根据潜在的原因和儿童的年龄以各种方式表现出来。这很容易被忽视,尤其是对于那些可能无法用语言表达问题所在的年幼儿童。虽然临床医生通常在评估继发于创伤的颈部疼痛时感觉更舒服,但很大一部分儿童是由医学原因引起的。许多颈部疼痛的病例是自行解决的,但一部分儿童将需要进一步调查或根据评估儿童时获得的重要和重要的临床发现紧急转诊。本文旨在概述创伤性和非创伤性颈部疼痛的治疗方法。它讨论了重要的特征,指出了一个更重要的潜在原因,并进行了最适当的调查。
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引用次数: 0
Hip and knee pain in adolescents 青少年的髋关节和膝关节疼痛
Q3 Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-17 DOI: 10.1016/j.paed.2025.12.001
Kuldeep K Stöhr, Arman Memarzadeh
Musculoskeletal pain, particularly in the hip and knee, is one of the most common presentations to primary care. In the UK, it is not uncommon for these children to find themselves in front of a paediatrician eventually. A swift and accurate diagnosis is expected from all and this article aims to demonstrate how that can be achieved within realistic limits. Failure to diagnose slipped capital femoral epiphysis and osteochondral fragments can result in significant disability and litigation. Informed management of common conditions such as patella instability or muscle strains can mean the difference between self-exclusion from normal sporting activities or safe participation and return to a full social environment.
肌肉骨骼疼痛,尤其是髋关节和膝关节疼痛,是初级保健最常见的症状之一。在英国,这些孩子最终发现自己在儿科医生面前并不罕见。一个快速和准确的诊断是期望从所有和这篇文章的目的是演示如何可以实现在现实的限制。未能诊断出股骨骨骺滑移和骨软骨碎片可导致严重的残疾和诉讼。对髌骨不稳定或肌肉拉伤等常见情况的知情管理可能意味着自我排除正常体育活动或安全参与并返回完整的社会环境之间的差异。
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引用次数: 0
Back on track: assessing back pain in children and young people 重回正轨:评估儿童和年轻人的背部疼痛
Q3 Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-03 DOI: 10.1016/j.paed.2025.12.003
Salma Shehabi, Kathryn Harrison
Back pain is increasingly common in children and adolescents, with potential impacts on quality of life and ability to perform activities of daily living. This article reviews paediatric back pain assessment and management, highlighting the importance of structured history taking and thorough physical examination to identify red flag symptoms. Causes are highlighted and include mechanical, developmental, inflammatory, infectious, and neoplastic conditions. Targeted investigations, such as lab tests, imaging, and genetic studies, are discussed. Management approaches emphasize a child-centred, holistic approach combining pharmacological and non-pharmacological interventions. Early detection and tailored management are essential to prevent chronic pain, disability, and missed serious pathology in children and young people.
背部疼痛在儿童和青少年中越来越常见,对生活质量和日常生活能力有潜在的影响。这篇文章回顾了儿科背痛的评估和管理,强调了结构化的病史记录和彻底的身体检查对识别危险症状的重要性。原因突出,包括机械,发育,炎症,感染和肿瘤条件。有针对性的调查,如实验室测试,成像和遗传研究,讨论。管理方法强调以儿童为中心,结合药物和非药物干预的整体方法。早期发现和有针对性的管理对于预防儿童和青少年的慢性疼痛、残疾和遗漏的严重病理至关重要。
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引用次数: 0
Extreme hypernatraemia in infancy, with a case of survival at 237 mmol/L: presentation, diagnosis, investigations, neuroradiology and outcomes 婴儿期极端高钠血症,237 mmol/L存活1例:表现、诊断、调查、神经放射学和结果
Q3 Medicine Pub Date : 2026-03-01 Epub Date: 2025-12-26 DOI: 10.1016/j.paed.2025.12.005
Muller Theubo, Shil Patel, Aleksandra Brutkowska, Éloise de Sousa, Arpita Chattopadhyay, Andrew Wignell, Dusan Raffaj, Patrick Davies
We report a term 6-week-old infant who presented with extreme hypernatraemia (peak serum sodium 237 mmol/L) due to exogenous salt ingestion, manifesting with lethargy, seizures, and haemodynamic instability. The child developed multi-organ failure, including cardiovascular collapse, renal impairment, and circulatory failure. Management focused on precise sodium titration via peritoneal dialysis supported by a bespoke sodium calculator. Despite two peri-arrest events, quintuple inotropic support, hyperkalaemia, and status epilepticus, multi-organ failure was reversed and serum sodium gradually normalized. Presentation, diagnosis, investigations, neuroradiology, and outcomes of extreme hypernatraemia are discussed. Survival at this level of serum sodium concentration has not previously been described, and the cellular and physiological effects were unknown. At 2 months post-admission, gross neurology appeared normal. A unilateral Syme amputation was required due to lower limb hypoperfusion. This case illustrates the challenges of managing severe hypernatraemia and the potential for recovery with meticulous titration strategies despite life-threatening complications.
我们报告了一例6周大的婴儿,由于外源性盐摄入而出现极端高钠血症(峰值血清钠237 mmol/L),表现为嗜睡、癫痫发作和血流动力学不稳定。患儿出现多器官衰竭,包括心血管衰竭、肾功能损害和循环衰竭。治疗的重点是通过腹膜透析进行精确的钠滴定,并辅以定制的钠计算器。尽管有两次停搏期事件,五次肌力支持,高钾血症和癫痫持续状态,多器官衰竭得到逆转,血清钠逐渐恢复正常。本文讨论了极端高钠血症的表现、诊断、调查、神经放射学和结果。在这一血清钠浓度水平下的生存率以前没有报道过,细胞和生理效应也未知。入院后2个月,神经大体正常。由于下肢灌注不足,需要进行单侧赛姆斯截肢。本病例说明了管理严重高钠血症的挑战,以及尽管有危及生命的并发症,但通过细致的滴定策略恢复的潜力。
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引用次数: 0
Marfan syndrome: diagnosis and management in childhood 马凡氏综合征:儿童的诊断和治疗
Q3 Medicine Pub Date : 2026-03-01 Epub Date: 2026-01-20 DOI: 10.1016/j.paed.2025.12.002
Anne H Child, Jose A Aragon-Martin, Sophia Kazmi, Nitha Naqvi
Marfan syndrome (MFS; OMIM #154700) is an important pleiotropic genetic connective tissue disorder affecting multiple systems in the human body. Early diagnosis is vital to prevent sudden premature death. Many affected individuals are asymptomatic; leading normal lives, unaware that their aorta is dangerously enlarging and prone to catastrophic dissection/tear leading to blood vessel rupture. Males and females of all races are affected equally. MFS is inherited in an autosomal dominant mode and is caused by a genetic variation in the Fibrillin 1 gene (FBN1; OMIM ∗134797) located on the long arm of chromosome 15 (15q21). In most cases, 75% have inherited the condition from a parent, with 25% having de novo mutations. The most important systems to be affected are cardiovascular, ophthalmic, and skeletal. MFS is a highly penetrant condition with substantial intra- and interfamilial variability. With drug treatment and cardiac surgery, early medical interventions can lead to a lifespan into the seventh decade. Without treatment unexpected death can occur from a young age. In 97% of affected individuals a causative mutation can be found thereby enabling preconception genetic diagnosis to potentially prevent further offspring being affected. This review focuses on the major challenges those affected experience during childhood.
马凡氏综合征(MFS; OMIM #154700)是一种影响人体多个系统的重要的多效性遗传性结缔组织疾病。早期诊断对于预防过早猝死至关重要。许多感染者没有症状;过着正常的生活,却不知道他们的主动脉正在危险地扩张,容易发生灾难性的剥离/撕裂,导致血管破裂。所有种族的男性和女性都受到同样的影响。MFS以常染色体显性模式遗传,由位于15号染色体(15q21)长臂上的纤维蛋白1基因(FBN1; OMIM∗134797)的遗传变异引起。在大多数情况下,75%的人从父母那里遗传了这种疾病,25%的人有新生突变。受影响最重要的系统是心血管系统、眼科系统和骨骼系统。MFS是一种高度渗透的疾病,具有大量的家族内和家族间变异性。通过药物治疗和心脏手术,早期的医疗干预可以使患者的寿命延长到70岁。如果不进行治疗,可能会在年轻时发生意外死亡。在97%的受影响个体中可以发现致病突变,从而使孕前遗传诊断能够潜在地防止进一步的后代受到影响。本综述的重点是受影响者在童年时期经历的主要挑战。
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引用次数: 0
Climate change and child health: the importance of global citizenship 气候变化与儿童健康:全球公民的重要性
Q3 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-24 DOI: 10.1016/j.paed.2025.11.008
Emily Broadis, Euan Fisher
Viewing climate change through the lens of child health brings focus to the uncomfortable realities of the geographical, intergenerational, and healthcare system injustices of today's world. Children are disproportionately affected, their developing bodies are more susceptible to the negative health impacts, and they are ultimately suffering because of the actions of generations before them. Whilst the challenges of climate change may feel overwhelming, global citizenship offers the paediatrician an outlook of hope and encouragement through positive collaborative action. Global citizenship is an awareness of being connected to people from all around the world, recognizing that decisions made locally can impact on those who may live in other continents, bringing a sense of responsibility for individual actions and the implications they may have for all people and the planet. This concept of a global community fosters equity and social justice, energizing people to work collaboratively to address local and global challenges in the shared endeavour for a healthy planet and population. This paper positions global citizenship as a route through which paediatricians can utilize their knowledge, skills, global community networks, and agency to contribute to climate action from a global child health perspective within their roles alongside UK clinical practice.
从儿童健康的角度看待气候变化,使人们关注到当今世界的地理、代际和卫生保健系统不公正等令人不安的现实。儿童受到的影响尤为严重,他们发育中的身体更容易受到负面的健康影响,他们最终遭受的痛苦是由于他们之前几代人的行为。虽然气候变化的挑战可能令人难以承受,但全球公民身份通过积极的合作行动为儿科医生提供了希望和鼓励的前景。全球公民意识是一种与世界各地的人联系在一起的意识,认识到当地做出的决定可能会影响到生活在其他大洲的人,对个人行为及其可能对全人类和地球产生的影响产生责任感。这一全球共同体的概念促进公平和社会正义,激励人们齐心协力,共同努力,应对地方和全球挑战,共同维护地球和人类的健康。本文将全球公民定位为一种途径,通过这种途径,儿科医生可以利用他们的知识、技能、全球社区网络和机构,在他们与英国临床实践的同时,从全球儿童健康的角度为气候行动做出贡献。
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引用次数: 0
Social protection for children: global landscape and domestic provision in the UK 儿童的社会保护:英国的全球格局和国内规定
Q3 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-30 DOI: 10.1016/j.paed.2025.11.007
Kirsty Robertson, Alison McLuckie
Social protection programmes are suggested by UNICEF as being a key intervention in the battle against global child poverty. Unfortunately, the provision of social protection programmes, including benefit provision, is unequal across the globe with children living in low income countries least likely to receive social security. The provision of adequate income for families to ensure children's needs are met requires a rights-based approach. Children's rights are universal and include the right to social security (Article 26), healthcare (Article 24), access to education (Article 28) and an adequate standard of living (Article 27). This article will discuss the global importance of social protection in the context ongoing concerns about high levels of child poverty as well as taking a closer look at the United Kingdom's welfare system with an emphasis on children and families.
联合国儿童基金会建议,社会保护方案是对抗全球儿童贫困的关键干预措施。不幸的是,社会保护计划的提供,包括福利的提供,在全球范围内是不平等的,生活在低收入国家的儿童最不可能获得社会保障。为家庭提供足够的收入以确保满足儿童的需要需要一种基于权利的办法。儿童的权利是普遍的,包括社会保障权(第26条)、保健权(第24条)、受教育权(第28条)和适足生活水准权(第27条)。本文将讨论社会保护在全球范围内的重要性,当前人们对儿童贫困问题的高度关注,并仔细研究英国的福利制度,重点是儿童和家庭。
{"title":"Social protection for children: global landscape and domestic provision in the UK","authors":"Kirsty Robertson,&nbsp;Alison McLuckie","doi":"10.1016/j.paed.2025.11.007","DOIUrl":"10.1016/j.paed.2025.11.007","url":null,"abstract":"<div><div>Social protection programmes are suggested by UNICEF as being a key intervention in the battle against global child poverty. Unfortunately, the provision of social protection programmes, including benefit provision, is unequal across the globe with children living in low income countries least likely to receive social security. The provision of adequate income for families to ensure children's needs are met requires a rights-based approach. Children's rights are universal and include the right to social security (Article 26), healthcare (Article 24), access to education (Article 28) and an adequate standard of living (Article 27). This article will discuss the global importance of social protection in the context ongoing concerns about high levels of child poverty as well as taking a closer look at the United Kingdom's welfare system with an emphasis on children and families.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"36 2","pages":"Pages 45-49"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of being a young carer and the support available 作为一个年轻的照顾者的影响和可用的支持
Q3 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-16 DOI: 10.1016/j.paed.2025.11.009
Joanna Coghill, Sharon Daniels, Denise Garner, Ruth Glenn
Young carers are children under the age of 18 who care for family members or friends. There are a significant number of young carers in the UK, with 2021 census data for England and Wales reporting at least 120,000 – however this is likely to be an under representation. Young carers are at higher risk of poor health, education and social outcomes. There is awareness of the challenges faced by young carers with clear legal frameworks, but access to services needs to be improved. A range of services and support mechanisms are available to young carers, including statutory assessments, localized support networks, and digital resources, though access and awareness remain inconsistent across regions.
青年照顾者是指照顾家庭成员或朋友的18岁以下儿童。英国有相当多的年轻看护人,2021年英格兰和威尔士的人口普查数据显示,至少有12万名年轻看护人,但这可能是不足的。年轻的照料者在健康、教育和社会结果方面面临更大的风险。在明确的法律框架下,人们意识到年轻照顾者面临的挑战,但需要改善获得服务的机会。青年照顾者可获得一系列服务和支持机制,包括法定评估、本地化支持网络和数字资源,但各地区的获取和认识仍然不一致。
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引用次数: 0
Over one in four UK children face food insecurity: what can paediatricians do? 超过四分之一的英国儿童面临食品不安全:儿科医生能做些什么?
Q3 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.paed.2025.11.006
Rosalyn Arnold, Rosalie Cattermole, David Taylor-Robinson, Dougal Hargreaves, Rachel Loopstra
In 2023–24, over one in four children in the UK – at least 3.9 million – lived in households without reliable access to food each month, as reported by the Department for Work and Pensions. This rate of child food insecurity has been described as amongst the worst in Europe. The consequences are profound and long lasting. Food insecurity affects children's physical health, emotional wellbeing, social and cognitive development and academic performance. Often, hospitals and general practices are sites where these impacts are first recognized. Yet paediatricians and other health professionals frequently report feeling powerless to respond to problems rooted in poverty and inadequate welfare support. This article aims to help paediatricians and other health professionals better understand food insecurity, its impact on children, current rates in the UK and the approaches being taken to address it. There are several ways health professionals can respond to food insecurity, and we highlight two case studies showing how hospitals, community services and charities are working together to respond to rising rates. Our aim is to equip paediatricians and other health professionals with a clearer sense of what they can do in their everyday roles. An infographic summarizing the key messages of this article is available at the end of this article.
根据工作和养老金部的报告,在2023 - 2024年,英国超过四分之一的儿童(至少390万)生活在每月无法获得可靠食物的家庭中。这一儿童食品不安全率被认为是欧洲最严重的。其后果是深远而持久的。粮食不安全影响儿童的身体健康、情绪健康、社会和认知发展以及学业成绩。通常,医院和全科诊所是最先认识到这些影响的场所。然而,儿科医生和其他卫生专业人员经常报告说,他们感到无力应对源于贫困和福利支持不足的问题。本文旨在帮助儿科医生和其他卫生专业人员更好地了解食品不安全,其对儿童的影响,目前在英国的比率和正在采取的方法来解决这一问题。卫生专业人员可以通过多种方式应对粮食不安全问题,我们重点介绍了两个案例研究,展示了医院、社区服务和慈善机构如何共同努力应对不断上升的粮食不安全问题。我们的目标是使儿科医生和其他卫生专业人员更清楚地了解他们在日常工作中可以做些什么。在本文的末尾有一个信息图,总结了本文的主要信息。
{"title":"Over one in four UK children face food insecurity: what can paediatricians do?","authors":"Rosalyn Arnold,&nbsp;Rosalie Cattermole,&nbsp;David Taylor-Robinson,&nbsp;Dougal Hargreaves,&nbsp;Rachel Loopstra","doi":"10.1016/j.paed.2025.11.006","DOIUrl":"10.1016/j.paed.2025.11.006","url":null,"abstract":"<div><div>In 2023–24, over one in four children in the UK – at least 3.9 million – lived in households without reliable access to food each month, as reported by the Department for Work and Pensions. This rate of child food insecurity has been described as amongst the worst in Europe. The consequences are profound and long lasting. Food insecurity affects children's physical health, emotional wellbeing, social and cognitive development and academic performance. Often, hospitals and general practices are sites where these impacts are first recognized. Yet paediatricians and other health professionals frequently report feeling powerless to respond to problems rooted in poverty and inadequate welfare support. This article aims to help paediatricians and other health professionals better understand food insecurity, its impact on children, current rates in the UK and the approaches being taken to address it. There are several ways health professionals can respond to food insecurity, and we highlight two case studies showing how hospitals, community services and charities are working together to respond to rising rates. Our aim is to equip paediatricians and other health professionals with a clearer sense of what they can do in their everyday roles. An infographic summarizing the key messages of this article is available at the end of this article.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"36 2","pages":"Pages 38-44"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Violence: understanding the public health approach to violence prevention and implications for violence prevention work with children and young people 暴力:了解预防暴力的公共卫生方法及其对儿童和青少年预防暴力工作的影响
Q3 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-11 DOI: 10.1016/j.paed.2025.11.005
Christine A Goodall, Ryan McHenry, Michael Whelan
Our understanding of the causes and impact of violence has developed over the years to the point where we recognize the profound and long-lasting impact that violence can have on children and young people. In this article we explore some of the impacts violence has on children and young people and how taking a public health approach can help us to develop opportunities for prevention at the primary, secondary and tertiary levels.
多年来,我们对暴力的起因和影响的理解已经发展到认识到暴力可能对儿童和青年产生深远和持久的影响的程度。在本文中,我们探讨了暴力对儿童和年轻人的一些影响,以及采取公共卫生方法如何帮助我们在小学、中学和大学各级创造预防机会。
{"title":"Violence: understanding the public health approach to violence prevention and implications for violence prevention work with children and young people","authors":"Christine A Goodall,&nbsp;Ryan McHenry,&nbsp;Michael Whelan","doi":"10.1016/j.paed.2025.11.005","DOIUrl":"10.1016/j.paed.2025.11.005","url":null,"abstract":"<div><div>Our understanding of the causes and impact of violence has developed over the years to the point where we recognize the profound and long-lasting impact that violence can have on children and young people. In this article we explore some of the impacts violence has on children and young people and how taking a public health approach can help us to develop opportunities for prevention at the primary, secondary and tertiary levels.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"36 2","pages":"Pages 31-37"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Paediatrics and Child Health (United Kingdom)
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