title: Epidemiology of musculoskeletal pain in a pediatric emergency department.
abstract: The objectives of this study were (1) to determine the percentage of emergency department (ED) visits due to musculoskeletal pain (MSP) by children 3-14 years of age during a period of 1 year; (2) to determine the most frequent presenting complaints; and (3) to characterize their etiology. A cross-sectional study was performed on children aged 3-14(11/12) years attended at the ED of a tertiary hospital due to MSP. The demographic and clinical characteristics of the patients were reviewed 5 days each month for 12 consecutive months. Study days were selected by computer-generated simple random sampling. Out of 4,531 visits to the ED, 826 were due to MSP (18.2 %; 95 % CI 17.1-19.4 %). When compared with children with no skeletal complaints, children with MSP had a similar sex distribution but were older (mean ± SD 7 ± 3.5 years vs 9.9 ± 3.1 years; p < 0.0001). The most common complaints were pain at the wrist (19 %), ankle (19 %) and finger (15 %). The most common etiology was trauma (88.4 %), including contusions (38 %), fractures (21 %) and sprains (18 %). Children with hip (6.7 ± 3 years; p < 0.0001) and elbow (7.8 ± 3.5 years; p < 0.0001) complaints were younger than children with pain in other locations, whereas children with wrist pain (10.5 ± 2.6 years; p < 0.002) and joint sprains (10.7 ± 2.7 years; p < 0.0001) were older. Fractures were more frequent in boys (64 vs 36 %, p = 0.008; OR 1.6; CI 1.1-2.2). Visits to the ED due to MSP increased with age. Pain at three locations represented 50 % of the presenting complaints. Trauma was the principal etiology, but fractures only represented one-fifth of the total.
authors.affiliation: Pediatric Rheumatology Unit, Hospital Universitario 12 de Octubre and Universidad Complutense de Madrid, Avda/Córdoba s/n, 28041, Madrid, Spain. jaime.inocencio@salud.madrid.org.
authors.forename: Jaime
authors.identifier: http://orcid.org/0000-0002-0438-0245
authors.initials: J
authors.lastname: de Inocencio
authors.affiliation: Emergency Department, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Carro
authors.affiliation: Emergency Department, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Flores
authors.affiliation: Emergency Department, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Carpio
authors.affiliation: Emergency Department, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Sofía
authors.initials: S
authors.lastname: Mesa
authors.affiliation: Emergency Department, Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Milagros
authors.initials: M
authors.lastname: Marín
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D013180:Sprains and Strains / Q000150:complications / Q000453:epidemiology*
keywords: Emergency hospital service; Epidemiology; Musculoskeletal pain; Pediatrics