Musculoskeletal disorders in children: a study in Dutch general practice

OBJECTIVE: This study focuses on the occurrence of musculoskeletal disorders in children presented in general practice. Known epidemiological studies addressing musculoskeletal diseases in childhood are scarce and based on a low number of episodes. DESIGN AND SETTING: Prospective study of all patient contacts in general practice. A total number of 161 general practitioners participated, divided into four groups, registering during four consecutive three-month periods. PATIENTS: All children younger than 15 years of age who visited their GP during the registration period. All diagnoses and working hypotheses concerning musculoskeletal disorders were selected. RESULTS: The total number of children in the study was 64,198. Disorders of the musculoskeletal system accounted for 3,699 (7.5%) of all 49,309 contacts and for 3,046 (7.5%) of all 40,340 episodes. Of the 3,046 episodes registered for ICPC-chapter L (musculoskeletal), 2,562 (84%) were new episodes, i.e. not presented to the GP before. Fifty-four percent of all new episodes were acute injuries. In 22% of the new episodes the general practitioner made a symptom diagnosis. Differences by age and sex were found for a limited number of diagnosis categories. CONCLUSION: Children present disorders of the musculoskeletal system less often than adults; they also present different disorders to their general practitioners. The majority of disorders presented by children are acute injuries, mostly sprains and strains.