FAQ Category: Child


Do you think it’s true that people of color are more likely to die from spinal fusion surgery for scoliosis compared with whites? I know this sounds like a weird question but our adopted child (who happens to be Hispanic) is scheduled for this kind of surgery. We are looking for any information we can find on the Internet about this surgery and found this stuff about deaths. Now I’m having second thoughts.

You might be referring to a recent study conducted by the staff at the Department of Neurosurgery, Cedars-Sinai Medical Center in Los Angeles, California. They wanted to assess national trends in the surgical treatment of idiopathic scoliosis, so they used information from the Nationwide Inpatient Sample or NIS to compare […]


Our 13-year-old daughter has scoliosis they call “idiopathic” because we don’t know what caused it. She never complains of pain but she is very self-conscious about her appearance. Is this ever a reason to have surgery to straighten her spine if there isn’t any pain?

This is a very good question. Treatment for scoliosis (curvature of the spine) is usually directed toward preventing deformity and minimizing any effects of the condition on daily function and quality of life (QOL). Quality of life covers a lot of territory including self-confidence, self-esteem, mood, and body image and […]


We took our 11-year-old daughter to a special spine clinic to have her scoliosis evaluated. They gave her a special questionnaire called an SRS. What is this and what does it measure? Does everyone take this test or only certain ones with scoliosis?

Every medical condition needs a tool to measure success of treatment. With idiopathic scoliosis (curvature of the spine with no known cause), the Scoliosis Research Society (SRS)-22 survey is often used. This tool was first developed and then published as a valid, reliable instrument back in the late 1990s. The […]


Our 23-month old son is having surgery on his little clubfeet because casting and splinting didn’t work. The surgeon is thinking that only one surgery will be needed but of course, no one knows for sure. What are the reasons why a child with this problem might need a second surgery? I’m not really sure how this works.

Clubfoot (also known by the medical term: equinovarus) describes a condition in which the foot is turned under and towards the other foot. Equinus means that the toes are pointed down and the ankle flexed forward (sort of like the position of the foot when a ballet dancer is on […]


Our daughter had surgery at age 18 months to correct a clubfoot that didn’t get better with casting. She’s now 11-years-old and wants to try out for the local girls’ soccer team. Should we try to discourage her and shield her from possible failure? Or let her try out and see what happens? I’m just not sure the leg is strong enough or that the surgery will hold up.

There aren’t a lot of studies with long-term results for surgical correction of clubfoot. Like your daughter, infants with equinovarus (medical term for clubfoot) are treated first with a conservative approach called the Ponseti method. This involves a series of casts used to gradually correct the alignment of the ankle […]


Can you please explain “islands of ossification in the posterior acetabulum” to me? I’m reading the MRI report on my 10-year-old son’s hip. He has been complaining of pain for months and we finally decided it wasn’t just “growing pains.” Now I see he has islands of ossification. Could that be causing the pain?

Hip pain in growing children isn’t always from “growing pains.” Children and young teens active in sports training and competition who have not yet completed their growth often develop hip pain. The bones are not fully formed yet. Formation of the bone in the posterior (back wall) of the acetabulum […]


If you can believe this, our seven-year-old daughter actually dislocated her hip playing softball (she slid into someone standing at home plate). The X-ray department took an X-ray but the radiologist refused to do an MRI (as suggested by another person evaluating our daughter). The radiologist said there’s nothing there but cartilage and it wasn’t “medically necessary.” Is that true?

There is some debate about what type of imaging studies are useful, needed, and helpful in diagnosing acute traumatic hip injuries in children. Age and gender (boys versus girls) are two important variables and we’ll explain why here in a minute. Children and young teens active in sports training and […]


I just saw on Facebook that my neighbor’s son is in surgery for a cut nerve in the forearm. He is a super basketball player and extraordinary musician. Will this put an end to all that? I want to be as supportive as possible and not ask too many questions like this so I thought you might be able to help fill in the gaps for me.

Nerve damage in the forearm from crush injuries or cuts can lead to significant disability. But nerves do heal even if at a very slow rate. In fact, studies show that with nerve repair, improvement can continue up to five years after the surgery. The keys to best outcomes are […]


What is loco-nosia? I heard this term on ESPN sports radio but didn’t catch the whole story. Evidently some basketball player cut two nerves in his forearm. There is some concern that he won’t get all his feeling back and this loco-stuff could affect his ball handling skills. Just wondering what it is…

Locognosia is the ability to tell where on the skin a person is touched (literally “knowlege of local touch”). It is one aspect of our ability to feel the difference when we are touched in two different places at the same time. This is called tactile spatial discrimination. Our touch […]


We are adopting a child from another country who has some hip problems. She started out with a hip infection that wasn’t treated. Then the hip dislocated. They said because she was “too old” (three years old) at the time, they couldn’t do surgery. We will definitely have her checked by our pediatrician and an orthopedic surgeon. What should we expect?

Infection of the hip joint that is undiagnosed and therefore untreated can lead to a condition known as septic arthritis. In young children, dislocation of the septic hip can be a challenge. According to a recent update on the management of septic hip dislocations from India, your adoptive daughter’s care […]


My seven-year-old niece had a hip infection that went undiagnosed and untreated until it dislocated. She recently came to live with us. The surgeons here are saying she’s not an “ideal” candidate for surgery. What does that mean exactly?

Infection of the hip joint that is undiagnosed and therefore untreated can lead to a condition known as septic arthritis. In young children, dislocation of the septic hip can be a challenge. For one thing, the hip that is not fully formed can look like it is dislocated when, in […]


I’ve heard that multiple sclerosis is more likely to occur in people raised in the northern areas of the globe. They said on television that they think the same is true for Perthes disease (which is what I have). In fact, they said the lowest rate of Perthes is at the equator. Any idea why that would be?

Research has indeed shown us that Legg-CalvĂ©-Perthes occurs more often in certain geographical areas. For example, children in Northern Europe have the highest rate of occurrence while children around the equator have the lowest incidence. In fact, for every 10 degree increase in latitude, the number of children affected by […]


My four-year-old grandson has to use crutches now to keep weight off his right hip because he has something called Perthes disease. So far he has enjoyed the attention and the novelty of using crutches. But I predict this won’t last. How long will he have to use crutches to get the desired healing effect?

Treating children with Perthes hip disease presents some interesting challenges. Current approaches include non-weight-bearing (not putting any weight on the leg) for long periods of time. Age is the determining factor in the treatment of this condition. Recovery is more likely in children under the age of eight. Many children […]


Our six-year-old son is VERY active in all kinds of sports already. But we just found out he has Perthes hip disease. Now he is supposed to stay off that leg for as long as it takes to heal. Is this really necessary? Isn’t it more important these days to stay active?

Perthes disease is a condition that affects the hip in children between the ages of four and eight. The condition is also referred to as Legg-Calve-Perthes disease in honor of the three physicians who each separately described the disease. In this condition, the blood supply to the growth center of […]


I am sending this to you from the children’s hospital where our three year old just had hip surgery. The nurses keep pushing drugs into this kid to “keep him comfortable” — is it really a good idea to put young children on narcotics like this? How do they even know he’s having any pain when he’s so drugged up? I’m really concerned.

It is a tough sell but patients undergoing surgery for any reason must take their pain medications as prescribed. That means the full amount as often as recommended. Many Americans still subscribe to the belief that if there’s “no pain, there’s no gain”. And they feel it is better to […]


Our middle-school soccer team has had a bunch of knee injuries. The coach asked two of us science nerds if we would find out more about some of the knee problems kids are getting from sports injuries. We are going to give a talk on it next week. Do you have any information that might help us with what’s the latest these days?

As more and more children and teens participate in organized sports at a younger age, it is no surprise that knee injuries are on the rise. A pediatric orthopedic surgeon from UCLA School of Medicine recently reviewed four specific injuries that might be of interest to you in your report. […]