title: Musculoskeletal conditions in children and adolescents managed in Australian primary care.
abstract: BACKGROUND
  Primary care settings play a vital role in the early detection and appropriate management of musculoskeletal conditions in paediatric populations. However, little data exist regarding these conditions in a primary care context or on the presentation of specific musculoskeletal disorders in children. The aim of this study was to estimate the caseload and describe typical management of musculoskeletal conditions in children and adolescents presenting to primary care in Australia.
  
  
  METHODS
  An analysis of data from the Bettering the Evaluation and Care of Health (BEACH) study was performed. The BEACH study is a continuous national study of general practice (GP) activity in Australia. We identified all GP encounters with children and adolescents over the past five years and extracted data on demographic details, the problems managed, and GP management of each problem. SAS statistical software was used to calculate robust proportions and after adjustment for the cluster, the 95% confidence intervals (CIs).
  
  
  RESULTS
  From the period April 2006 to March 2011, there were 65,279 encounters with children and adolescents in the BEACH database. Of the 77,830 problems managed at these encounters, 4.9% (95%CI 4.7% to 5.1%) were musculoskeletal problems. The rate of musculoskeletal problems managed increased significantly with age, however there was a significant decrease for girls aged 15-17 years. Upper and lower limb conditions were the most common, followed by spine and trunk conditions. Spine and trunk conditions were significantly more likely to be managed with medication, but less likely to receive imaging, than upper or lower limb problems.
  
  
  CONCLUSIONS
  Musculoskeletal problems in children and adolescents present a significant burden and an important challenge to the primary health care system in Australia. There is variability in rates of presentation between different age groups, gender and affected body region.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia. henschke@uni-heidelberg.de.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Henschke
authors.forename: Christopher
authors.initials: C
authors.lastname: Harrison
authors.forename: Damien
authors.initials: D
authors.lastname: McKay
authors.forename: Carolyn
authors.initials: C
authors.lastname: Broderick
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.forename: Helena
authors.initials: H
authors.lastname: Britt
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Maher
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D011320:Primary Health Care / Q000592:standards* / Q000639:trends