Orthopaedics 11-18 Years: Adolescence
Guide to adolescent orthopaedic conditions: scoliosis, kyphosis, Osgood-Schlatter, SCFE. The growth spurt and its challenges.
The Growth Spurt: A Critical Window
Adolescence brings rapid growth—up to 10cm per year. This makes it both a vulnerable time (conditions can progress quickly) and an opportunity (bones still respond well to treatment). Monitoring during this period is crucial.
Key Conditions to Know
Scoliosis
Lateral spinal curvature. Peak detection during growth spurt. Girls more commonly affected. Early detection allows conservative treatment.
Signs to watch:
- Uneven shoulders or waist
- Rib hump when bending forward
- Clothes hanging unevenly
Action:
School screening or home Adams test. Evaluation within 1-2 months if positive.
Scheuermann's Kyphosis
Excessive rounding of upper back, beyond postural. Affects vertebral growth plates. More common in boys.
Signs to watch:
- Rounded upper back that doesn't correct with effort
- Upper back pain with prolonged sitting
- Tight hamstrings
Action:
Evaluation if visible roundness persists despite good posture habits.
Osgood-Schlatter Disease
Knee pain at the tibial tubercle (bump below kneecap). Very common in active adolescents. Activity-related.
Signs to watch:
- Pain below kneecap during/after sports
- Visible bump that may be tender
- Worse with kneeling or jumping
Action:
Activity modification, stretching. Evaluation if limiting sports participation.
Slipped Capital Femoral Epiphysis (SCFE)
URGENTHip condition where growth plate slips. URGENT. More common in overweight adolescents. Can cause permanent damage if delayed.
Signs to watch:
- Hip, groin or knee pain
- Limping or walking with foot turned out
- Limited hip rotation
Action:
URGENT evaluation. Do not bear weight. Go to ER if suspected.
Sports & Adolescence
Intensive sports during growth spurt increase injury risk. Common issues include heel pain (Sever's), knee pain (Osgood-Schlatter, Sinding-Larsen), and stress fractures. Balance is key: sport is beneficial, but overtraining is harmful.
Read about sports injuries