Boy’s knee pain must be looked at

The Weekend Australian - Travel - - Resources - LINDA CAL­ABRESI

In re­cent months my six-year-old son has started com­plain­ing of pain in his left knee af­ter short pe­ri­ods of run­ning around. He says the pain is on the outer side of his knee, and even though the area is not painful to touch, and does not ap­pear swollen, he does limp when it oc­curs. Do you think I should do any­thing about this, or is it likely to get bet­ter by it­self? WHILE many such com­plaints in chil­dren do get bet­ter by them­selves, it would still be worth­while get­ting your son med­i­cally checked. There are a num­ber of pos­si­ble causes of the pain, in­clud­ing pos­tural anom­alies and prob­lems re­lated to the kneecap. In­fec­tion is un­likely be­cause of the lack of red­ness and swelling, but it still needs to be ruled out. An­other im­por­tant dis­ease to check for is Perthes dis­ease of the hip. Hip con­di­tions of­ten cause re­ferred pain to the knee, and this can be the first sign of a prob­lem. Perthes dis­ease most com­monly oc­curs in chil­dren aged 6-10 years. In this con­di­tion there is a prob­lem with the blood sup­ply to the ball-shaped head of the thigh bone (fe­mur). This causes a soft­en­ing of the joint sur­face which can, with time, lead to the femoral head be­com­ing flat­tened or de­formed in some way. The femoral head is the ball part of the ball-and-socket joint that is the hip, so dam­age to it will have long-term con­se­quences — not only in mov­ing and flex­i­bil­ity, but also the risk of de­vel­op­ing arthri­tis down the track. While most chil­dren with Perthes dis­ease will re­cover com­pletely, it is im­por­tant to de­tect the prob­lem early. I am56 and in good health. I am con­sid­er­ing tak­ing gingko ex­tract tablets to ward off any ill-ef­fects of age on my me­mory. Do you con­sider this worth­while? THIS is a con­tro­ver­sial topic. Gingko biloba has been pro­moted as hav­ing ben­e­fi­cial ef­fects for many med­i­cal con­di­tions, in­clud­ing de­men­tia, pe­riph­eral vas­cu­lar dis­ease, ver­tigo, im­po­tence as well as me­mory de­te­ri­o­ra­tion. And there is ev­i­dence to sug­gest it can have a pos­i­tive ef­fect in peo­ple with pre-ex­ist­ing vas­cu­lar dis­ease. How­ever, in peo­ple with no such un­der­ly­ing dis­ease, the stud­ies have shown mixed re­sults and the gen­eral feel­ing is that in this group, gingko does not ap­pear to make any dif­fer­ence. It might be worth dis­cussing the is­sue with your doc­tor to as­sess your risk of vas­cu­lar dis­ease. I ama 73-year-old man with wide­spread arthri­tis and hae­mochro­mato­sis. I am hav­ing blood taken ev­ery week to re­duce my iron lev­els. Is there any al­ter­na­tive to this, as they are hav­ing in­creas­ing prob­lems find­ing a vein? Also, de­spite this reg­u­lar blood-let­ting, my iron lev­els have in­creased. Is there any spe­cial diet I should be fol­low­ing? AS far as I amaware, reg­u­lar blood-let­ting, or phle­botomy, re­mains the treat­ment of choice for re­duc­ing the high iron lev­els in your blood caused by your ge­netic pre­dis­po­si­tion to in­creased iron ab­sorp­tion. It sounds as though you have been di­ag­nosed with hae­mochro­mato­sis rel­a­tively re­cently, as most peo­ple with the dis­ease do not need a phle­botomy quite so of­ten. As for diet, you should ob­vi­ously not take iron sup­ple­ments, but this in­cludes break­fast ce­re­als for­ti­fied with iron. Most ex­perts do not ad­vo­cate an iron-free diet as that would have im­pli­ca­tions for other as­pects of nu­tri­tion, but they do sug­gest a re­stricted in­take of iron-rich food such as meat and of­fal. Avoid vi­ta­min C sup­ple­ments, as vi­ta­min C pro­motes iron ab­sorp­tion. Al­co­hol should be avoided as well — it can com­pound iron over­load ef­fects on the liver. Linda Cal­abresi is ed­i­tor of Path­way , the mag­a­zine of the Royal Col­lege of Pathol­o­gists of Aus­trala­sia, and a Syd­ney GP. Send your queries to lin­da­cal­abresi@gmail.com

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