History

History taking in paediatric musculoskeletal medicine is not the same as in adults. The history may be primarily from the parent or caregiver, and may consist of only vague complaints, such as 'leg hurts’, ‘my child is not right’, or ‘she has stopped doing x’.

However, no matter the age of the child, effort should be made to ask them simple, age-appropriate questions. In younger children, this helps to empower and engage them in the visit and make them feel less intimidated. In older children and especially adolescents, this can help differentiate concerns of the patient from those perceived by the parent/caregiver.

It is important to modify your history taking style when engaging with children and young people, use appropriate language and tone and be alert to non-verbal clues of discomfort, fear or embarrassment.

You can often gather important information from watching the child as they enter the room and play with toys - look how they interact with parent(s), siblings or members of the health care team and other staff in the clinic.

There is no better way to learn than to observe experienced clinicians engage with children and for you to get feedback on your technique from observers. 

This module covers the important features in the history, including, "what to ask about", red flags needing immediate concern and attention, pain assessment and how to differentiate between inflammatory and mechanical problems.

More information is available about gait and motor milestones.  Top Tips are also available.