Pediatric Orthopaedic Conditions: Diagnosis and Treatment in Milan
The musculoskeletal system of children develops in a unique way. Many conditions that concern parents—such as flat feet or knock-knees—are part of normal growth. As a pediatric orthopaedic specialist at Gaetano Pini and CTO Milan, I help distinguish between physiological variants and true pathologies.
Common problems in children and teenagers
The reasons parents most often ask for an assessment.
Search and filter conditions
All pediatric orthopaedic conditions
60 conditions
Pes Planus (Flatfoot)
Flat feet in young children are usually a normal developmental variant. Assessment criteria and when orthotics may help.
Tarsal Coalition
Foot pain and hindfoot rigidity in a sporty adolescent can point to a tarsal coalition: how it is diagnosed and treated.
Juvenile Hallux Valgus
Juvenile hallux valgus needs monitoring over time: the choice between observation and surgery depends on severity, symptoms and skeletal maturity.
Genu Valgum & Genu Varum
Knock knees or bow legs are a normal part of growth at certain ages. What matters is age, symmetry, progression and residual growth.
Scoliosis
Assessing a spinal curve: classification, bracing criteria and when a specialist referral is needed.
Pediatric Fractures
Pediatric fractures aren't simply smaller adult fractures. When a pediatric orthopaedic check-up is useful after trauma or an ER visit.
Physeal Fractures
Fractures near a joint in children can involve the growth plate: a pediatric orthopaedic assessment is needed to evaluate the risk.
Sports Traumatology
Sprains, strains and overload pain in young athletes: evaluation and criteria for return to sport.
SCFE (Slipped Capital Femoral Epiphysis)
URGENT: Adolescent hip pain + limping. Seek immediate evaluation if knee/groin pain in overweight teen. Milan specialist.
Legg-Calvé-Perthes Disease
A limping child aged 4-8 without trauma warrants evaluation, especially with hip pain or morning stiffness.
Developmental Dysplasia of the Hip
Hip ultrasound findings in newborns: Graf classification, when a Pavlik harness is indicated, treatment duration and expected outcomes.
Congenital Clubfoot (CTEV)
Clubfoot is treated with serial casting using the Ponseti method, percutaneous Achilles tenotomy in most cases and a maintenance brace.
Browse 48 more conditions
Idiopathic Toe Walking
Toe walking is common up to about age 3. It becomes relevant if it persists, or is associated with Achilles tightness or motor delay.
Limb Length Discrepancy
One leg shorter than the other: how a structural difference differs from an apparent one, when a shoe lift helps, and how surgical options are assessed.
Kyphosis & Scheuermann Disease
A hunched back in adolescence: the difference between postural kyphosis and Scheuermann's disease, and when bracing is indicated.
Congenital Muscular Torticollis
Head tilt in the newborn from muscular fibrosis: assessment is warranted if the tilt persists or is associated with facial asymmetry.
Femoral & Tibial Torsion
Walking with feet turned inward or outward: the rotational profile involves the hip, leg and foot, and in most children evolves spontaneously with growth.
Out-toeing Gait
Walking with feet turned outward: assessed as part of the overall rotational profile of the limb to determine whether follow-up is needed.
In-toeing Gait
Walking with feet turned inward and frequent tripping: in most cases a torsional pattern that improves with growth.
Sever Disease & Apophysitis
Heel or knee pain in young athletes aged 8-15: overload conditions of the growth cartilage that need assessment if persistent or limiting.
Pes Cavus (Cavus Foot)
A markedly high arch: cavus foot needs to be distinguished between constitutional forms and those requiring neurological assessment.
Hindfoot Valgus
Heel tilted outward, often together with flatfoot: relevant if rigid, painful or asymmetric.
Anterior Knee Pain
Anterior knee pain in adolescents rarely has a single cause: sports overload, imperfect neuromuscular control and rapid growth often combine.
Neonatal Screening
Complete orthopaedic evaluation in newborn: hips, spine, feet, torticollis.
Orthopaedic Check-up
Preventive orthopaedic evaluation at key stages of growth.
Posture Evaluation
Assessment of posture and postural defects in developmental age.
Nursemaid's Elbow
A pulled arm the child stops moving: nursemaid's elbow is common under age 5; the diagnosis is clinical and treatment is a medical reduction manoeuvre.
Juvenile Osteochondroses
Distinct overload conditions of apophyses and ossification centres in young athletes — not generic 'growing pains'.
Non-Ossifying Fibroma
Benign bone lesion: reassurance on a common incidental finding.
Osteochondroma (Exostosis)
Benign bony growth: when to observe and when to operate.
Hereditary Multiple Exostoses (HME)
Hereditary condition with multiple exostoses: long-term follow-up and surgical management.
Simple Bone Cyst
Benign bone cavity: fracture risk, injections, and surgical management.
Patellar Dislocation
Kneecap dislocation in children: evaluation, conservative and surgical treatment.
Metatarsus Varus
Neonatal forefoot deformity: evaluation, mobilizations and treatment.
Groin and pubic pain in the young athlete
Groin pain during sports affects young soccer players and athletes: causes, diagnosis and recovery pathway.
ASIS Avulsion Fracture
Sudden hip pain during a sprint or kick: an ASIS avulsion fracture affects adolescent athletes and needs prompt diagnosis.
AIIS Avulsion Fracture
Acute groin pain after a missed kick: an AIIS avulsion is typical of young soccer players.
Osgood-Schlatter Disease
Pain below the knee after sports: Osgood-Schlatter disease is the most common cause in adolescents and needs proper assessment to guide treatment.
Sever's Disease
Heel pain after sports: Sever's disease is the most common apophysitis in children aged 8-14.
Sinding-Larsen-Johansson Syndrome
Pain at the base of the kneecap: Sinding-Larsen-Johansson syndrome is an apophysitis typical of ages 10-14.
Köhler's Disease
A 3-7 year old limping with foot pain: Köhler's disease is an osteochondritis of the tarsal navicular.
Freiberg's Disease
Forefoot pain when walking in a teenage girl: Freiberg's disease is a metatarsal osteonecrosis typical of ages 12-18.
Iselin's Disease
Pain on the outer edge of the foot after sports: Iselin's disease is often mistaken for a sprain.
Panner's Disease
Elbow pain after gymnastics or throwing: Panner's disease is an osteochondritis typical of ages 5-10.
Pectus Carinatum
Protruding sternum: pectus carinatum is assessed for flexibility and progression; a compressive brace can help flexible forms, while rigid or severe forms are referred to a thoracic surgeon.
Pectus Excavatum
Sunken sternum: when pectus excavatum requires cardiac evaluation, a vacuum bell, or the Nuss procedure.
Isthmic Spondylolysis and Spondylolisthesis
Low back pain after sports involving repeated hyperextension (gymnastics, dance, soccer): a pattern that should raise suspicion of spondylolysis.
Septic Arthritis of the Hip
Joint infection — URGENT. Watch for fever + limping + refusal to bear weight in a child. Prompt evaluation.
Osteochondritis Dissecans of the Knee
Recurrent knee pain in a young athlete, swelling, catching or locking sensations? Osteochondritis dissecans (OCD) of the knee is an osteochondral lesion that needs dedicated assessment: skeletal age, site and fragment stability guide the pathway.
Transient Synovitis of the Hip
Temporary inflammation of the hip causing a sudden limp. A benign picture, but it must be distinguished from septic arthritis.
Tibial eminence (tibial spine) fracture
The paediatric equivalent of an ACL injury: the ligament stays intact but avulses a bony fragment from the tibial plateau. Treatment depends on how far the fragment is lifted.
Fracture of the base of the fifth metatarsal in children
Pain on the outer border of the foot after a sprain: in children the fifth metatarsal base may show an apophysitis, an avulsion fracture or, less often, a Jones fracture. Site, age and displacement change treatment.
Seymour fracture (open distal phalanx fracture with nail bed injury)
A crushed fingertip with a lifted nail and blood under the nail plate: a Seymour fracture is an open fracture of the nail bed. It requires urgent assessment because of the risk of infection.
Paediatric trigger thumb
The child's thumb stays bent at the last joint and a small nodule is felt at its base: this is paediatric trigger thumb. A proportion resolves spontaneously; the other options are observation, selective splinting and surgery.
Congenital clasped thumb
The thumb stays folded into the palm and the child struggles to bring it out: in congenital clasped thumb the limitation involves extension of the metacarpophalangeal joint. Flexible forms often respond to early splinting.
Clinodactyly
A finger, most often the little finger, curves sideways in the plane of the hand. In most cases clinodactyly is a mild, asymptomatic variant: function, progression and, when relevant, associated conditions are assessed.
Camptodactyly
A finger, most often the little finger, stays bent at the middle joint and does not fully straighten. Flexible forms are managed with stretching and splinting; surgery is selective and recurrence is possible.
Syndactyly
Two or more fingers joined together from birth. Syndactyly may be simple or complex, complete or incomplete: surgical timing is individualised and surgery is performed in a paediatric hand surgery centre.
Growing pains
Leg pain is common in childhood: what the typical picture looks like, which features are less typical and what is examined during the consultation.
Paediatric knee pain
An orientation page on knee pain during growth: groups of causes, the role of the hip and when a consultation can help.