What to Expect from the Orthopaedic Visit
What happens during a paediatric orthopaedic visit: history, gait and functional observation, clinical examination and an individual plan.
Your first paediatric orthopaedic visit
Video · 60 seconds · English audio and subtitles
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The visit is not a fixed checklist
A child with heel pain, a toddler who walks on tiptoe and an adolescent with a limp need different examinations. The sequence below explains the reasoning, not a rigid timetable: the time spent on each part changes according to the clinical question and the child's cooperation.
STEP 1
History
We reconstruct when the problem started, how it changes with activity or growth, previous injuries and treatments, development, family history and sport. In many paediatric conditions this context is as important as the painful point itself.
STEP 2
Observation and function
When useful, I observe standing, walking, running or a sport-related movement. Children may move differently in the clinic, so a short home video can add useful information.
STEP 3
Clinical examination
The examination is adapted to the child's age and problem. It may include joint motion, strength, flexibility, alignment, limb length, gait and specific clinical tests. Some manoeuvres can reproduce the symptom we are trying to understand; they should not be forced unnecessarily.
STEP 4
Diagnosis and plan
At the end we put the findings together and decide whether observation is enough or whether imaging, a brace, physiotherapy, selected home exercises, sport modification or further treatment is useful. Tests are requested for a clinical reason, not automatically.
What is especially useful to bring
- Previous X-rays or MRI images as well as their reports, when available
- Reports from previous visits, emergency care, surgery or physiotherapy
- A short video if limping, toe walking or a sport-specific movement is intermittent
- The shoes, brace or orthosis involved in the problem when relevant
A child who feels at ease can be assessed better
The goal is not to 'get through' an examination at any cost. Giving the child time, explaining what is happening and observing spontaneous movement often makes the assessment more useful, especially in younger children.
If pain, limping, deformity or a sporting problem is persisting, the useful next step is an examination that identifies the cause rather than choosing a treatment from symptoms alone.
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