Journal of paediatrics and child health最新文献

{"title":"Developmental and Psychological Concerns in Children With Complex Congenital Heart Disease: The Need for a Screening Program","authors":"Ashani Mahawattege,&nbsp;Karina Laohachai","doi":"10.1111/jpc.70032","DOIUrl":"10.1111/jpc.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Complex congenital heart disease (CHD) is associated with adverse neurodevelopmental and psychological outcomes. Limited Australian data exist regarding these outcomes or follow-up. This cross-sectional study aims to determine the prevalence of developmental and psychological concerns in South Australian children with complex CHD and concurrent developmental or psychological healthcare utilisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Families of children with complex CHD aged between 3 years and 7 years 11 months undertook a series of validated screening questionnaires for development (Parents' Evaluation of Developmental Status [PEDS], Parents' Evaluation of Developmental Status—Developmental Milestones [PEDS:DM]) and mental health (Strengths and Difficulties Questionnaire [SDQ]). Demographic data, cardiac history, comorbidities, and current healthcare engagement was determined through standardised patient information questionnaires and medical records. Rates of developmental and psychological concern were determined and compared to Australian general population data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-five participants enrolled in the study. The most common cardiac diagnoses were Transposition of the Great Arteries (<i>n</i> = 13) and Tetralogy of Fallot (<i>n</i> = 11). Predictive developmental domain/s of concern were highly prevalent utilising both PEDS (57%) and PEDS:DM (70%) screening tools, exceeding Australian population rates (22%). Psychological concern (28%) also exceeded Australian population data (10%). Nearly half of participants identified to have developmental or psychological concern/s had no current general paediatric, allied health or mental health professional engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Developmental and psychological concerns detected on screening in children with complex CHD significantly exceed Australian general population prevalence rates. Without an established screening program, a large proportion of participants did not have active follow-up, indicating the importance of routine screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"777-786"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extreme Sinus Bradycardia in a 36-Week Neonate Caused by De Novo Short QT Syndrome: A Case Report","authors":"Nicole Minto,&nbsp;James Tong","doi":"10.1111/jpc.70026","DOIUrl":"10.1111/jpc.70026","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"806-809"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Hammersmith Infant Neurological Examination and Bayley Scales of Infant Development in High-Risk Infants: A Retrospective Cohort Study","authors":"Meagan Roff,&nbsp;Brendan Tian,&nbsp;Emily Johnston,&nbsp;Vathana Sackett,&nbsp;Annie Bourke,&nbsp;Pramod Pharande,&nbsp;Lindsay Zhou,&nbsp;Abdul Razak,&nbsp;Atul Malhotra","doi":"10.1111/jpc.70031","DOIUrl":"10.1111/jpc.70031","url":null,"abstract":"&lt;p&gt;Extremely premature, extremely low birth weight and neonates with significant brain injury in the neonatal period are at high risk for developmental delays. Early prognostication of developmental outcomes in high-risk infants is crucial for implementing early intervention to improve long-term development.&lt;/p&gt;&lt;p&gt;The Hammersmith Infant Neurological Examination (HINE) is a standardised tool for assessing neurological function in infants aged 2–24 months corrected age [&lt;span&gt;1&lt;/span&gt;]. It has been shown to reliably predict cerebral palsy from 3 to 4 months corrected age in high-risk infants. However, while early diagnosis of cerebral palsy is crucial, developmental delays are far more common, highlighting the importance of exploring the HINE's potential utility in predicting developmental delays, which remains unclear [&lt;span&gt;2&lt;/span&gt;]. The Bayley Scales of Infant Development (BSID) assess cognitive, motor and language skills and identifies developmental delays between 1 and 42 months of life [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This study aimed to evaluate the association between HINE assessments at 3–4 months corrected age and BSID-III or IV assessments between 24–36 months corrected age in high-risk infants. This retrospective cohort included high-risk infants assessed at Monash Children's Hospital, Australia, from 2019 to 2024. Eligible infants were born extremely preterm (&lt; 29 weeks), or had extremely low birth weight (&lt; 1000 g), or had significantly abnormal neonatal neuroimaging findings (moderate to severe hypoxic-ischaemic encephalopathy [HIE], grade ≥ 2 intraventricular haemorrhage, cystic periventricular leukomalacia).&lt;/p&gt;&lt;p&gt;HINE total scores and sub-scores (cranial nerve, posture, movements, tone, reflexes) were correlated with BSID composite scores (cognition, language, motor) using Spearman's or Pearson's correlation coefficients depending on distribution (Shapiro–Wilk Test). Statistical significance was defined as &lt;i&gt;p&lt;/i&gt; value &lt; 0.05. A subgroup analysis of infants with significantly abnormal neuroimaging was performed.&lt;/p&gt;&lt;p&gt;A total of 163 infants were included; the median (IQR) gestational age (GA) was 27 (25–30) weeks, and birth weight was 837 (666–1043) grams. Of these, 136 (83.4%) infants were born &lt; 29 weeks GA and/or &lt; 1000 g and 27 (16.6%) had HIE. In the subgroup of 49 infants with significantly abnormal neuroimaging, 22 (44.9%) were born &lt; 29 weeks GA and/or &lt; 1000 g and 27 (55.1%) had HIE. Cerebral palsy was diagnosed in 16 (9.8%) of the total cohort and 11 (22.4%) of the subgroup at 2–3 years.&lt;/p&gt;&lt;p&gt;Infants had a median (IQR) HINE total score of 55 (49–61) and median (IQR) BSID scores of 76.5 (60–95) for cognition, 79 (67–97) for language and 79 (64–91) for motor skills.&lt;/p&gt;&lt;p&gt;Table 1 summarises the HINE and BSID correlation outcomes. HINE total score showed a significant positive correlation with language outcomes (coefficient 0.16, 95% CI: 0.00–0.31, &lt;i&gt;p&lt;/i&gt; &lt; 0.05) but no significant correlation with cogn","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"825-827"},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do the American Academy of Paediatrics Guidelines for Managing Febrile Infants Aged 22 to 28 Days Work for a Suburban Australian Emergency Department? A Retrospective Audit","authors":"Claudia O'Rourke,&nbsp;David Krieser,&nbsp;Areeba Athar,&nbsp;Vidanka Vasilevski,&nbsp;Linda Sweet,&nbsp;Doris Tham","doi":"10.1111/jpc.70025","DOIUrl":"10.1111/jpc.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The American Academy of Paediatrics (AAP) 2021 guideline on the management of febrile infants provides a separate algorithm for the 22- to 28-day-old infant. Provided a specific combination of inflammatory markers is in the low-risk range, lumbar puncture (LP) and empiric antibiotics are optional. The Australian guidelines recommend LP and empiric antibiotics in all febrile neonates (&lt; 29 days). We describe the management of this age group over 8 years and review how using the AAP guideline would alter management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-centre retrospective chart review was conducted at Sunshine Hospital, Melbourne. The medical records of 50 consecutive well-appearing febrile infants aged 22–28 days were reviewed. Data on investigations, antibiotics, and duration of hospital stay were compared to the AAP recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 45 patients who met the inclusion criteria, 31% had no LP and 18% were observed without antibiotics. In the setting of normal inflammatory markers, these proportions increased to 48% and 27% respectively. All infants with abnormal inflammatory markers received these interventions. Using the AAP algorithm, 51% of patients would have been eligible for observation without LP or antibiotics. Two cases of bacteraemia were identified, both with abnormal inflammatory markers. Most infants were observed for 48 h (77%), with smaller proportions observed for 36 h (16%) and 24 h (7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicians frequently perform a more limited septic evaluation in 22- to 28-day-old infants when inflammatory markers are normal. A revised approach to fever in this age group could reduce unnecessary LP and antibiotic use by up to 50%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"771-776"},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Masses in Childhood: An Australian Perspective","authors":"S. M. Trinder,&nbsp;C. Kiraly-Borri,&nbsp;H. Dholaria,&nbsp;A. Charles,&nbsp;D. J. Roebuck,&nbsp;A. L. Ryan","doi":"10.1111/jpc.70021","DOIUrl":"10.1111/jpc.70021","url":null,"abstract":"<div>\u0000 \u0000 <p>Childhood renal masses comprise a heterogeneous group of conditions that have a wide range of presentations. This review outlines an approach to the diagnostic work-up of childhood renal masses and discusses the most common presentations and treatments. Renal tumours make up 5% of childhood cancer in Australia, with Wilms tumour being the most common under age 10 years. Significant advances have been made through global cooperative efforts to improve the understanding of biology, genetic basis, and classification of disease as well as standardise treatment protocols. As survival outcomes have improved, a focus on surveillance of the late effects of treatment is important. Around 10%–15% are related to cancer predisposition syndromes, and therefore consideration of this is critical at diagnosis and throughout care. Early involvement of a multi-disciplinary team is essential to ensure accurate diagnosis and management for these children and their families. Australia holds a unique perspective, as both European (SIOP) and North American (COG) treatment approaches are adopted across its paediatric oncology centres for malignant tumours. This results in flexibility in patient management but also necessitates careful decision-making regarding protocol selection.</p>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 6","pages":"836-845"},"PeriodicalIF":1.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Eczematous Rashes Surrounding Multiple Melanocytic Nevi in a Young Paediatric Patient","authors":"Chon-Wai Jeremy Chan,&nbsp;Matthew Verheyden,&nbsp;John Relic","doi":"10.1111/jpc.70024","DOIUrl":"10.1111/jpc.70024","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"651-652"},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Risk Factors for Brain Injury in Infants With Small Gestational Age and Construction and Evaluation of Prediction Model","authors":"Qunfang Shi,&nbsp;Ye Yang,&nbsp;Ling Wang,&nbsp;Yu Wang","doi":"10.1111/jpc.70019","DOIUrl":"10.1111/jpc.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate brain injury risk factors in small for gestational age (SGA) infants, develop and validate a risk prediction model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medical records from 326 SGA infants in the Neonatal Intensive Care Unit at Hebei University's Affiliated Hospital from September 2019 to September 2024 were reviewed. The infants were categorised into brain injury (<i>n</i> = 135) and no brain injury (<i>n</i> = 191) groups based on cranial MRI outcomes. Risk factors for brain injuries in SGA infants were identified through both univariate and multivariate logistic regression analyses, followed by constructing a nomogram to visualise these risk determinants. The predictive model's calibration, discrimination, clinical net benefit, and clinical usefulness were verified using calibration and ROC curves, along with decision curve analysis (DCA) and clinical impact curves (CIC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant risk factors included advanced maternal age, gestational hypertension (GH), fetal distress, reduced gestational age, neonatal septicemia, abnormal platelet counts and elevated neutrophil-to-lymphocyte ratio (NLR). The calibration curve and Hosmer–Lemeshow test verified the model's high accuracy. The model demonstrated good discrimination with an ROC curve AUC of 87.4%. Both DCA and CIC evaluations indicated the model's high clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The developed multivariate logistic regression model effectively predicts the risk of craniocerebral injuries in SGA infants, serving as a valuable tool for early identification of at-risk neonates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"759-770"},"PeriodicalIF":1.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fathers' Involvement in a Surgical Neonatal Intensive Care Unit: A Prospective Cohort Study","authors":"Karanbir Kaur,&nbsp;Priya Govindaswamy,&nbsp;Amit Trivedi,&nbsp;Sharon Laing","doi":"10.1111/jpc.70017","DOIUrl":"10.1111/jpc.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To date, studies exploring patterns of fathers' involvement in their neonate's care in the neonatal intensive care unit (NICU) and barriers to involvement have utilised qualitative approaches, which can be time- and resource-consuming. This study aimed to explore the fathers' involvement in a surgical NICU using a novel tool along with identifying potential facilitators and barriers to fathers' involvement in their neonate's care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-centre prospective cohort study was conducted at a surgical NICU (SNICU). A novel questionnaire, Fathers' Involvement Questionnaire: Neonatal Intensive Care Unit (FIQ:NICU) comprising four sections, was developed based on current evidence and expert consensus. Study data were collected and managed using REDCap electronic data capture tools. Involvement scores are reported for individual items, subscales (Physical contact, Verbal Interaction, During Procedures, Cares/Feeding, Participation in rounds), and total score (possible range 0–92). Associations between subscales and total FIQ scores and confidence levels were explored using bivariate correlation (Pearson's <i>r</i>).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two fathers participated. Total FIQ:NICU scores ranged from 20 to 74, mean score 55.1 (95% confidence interval 49.9–60.2), SD 14.24. Fathers reported the highest level of involvement in ‘During Procedures’ subscale (<i>M</i> = 2.88, SD = 1.00) and the lowest involvement in ‘Cares/Feeding’ (<i>M</i> = 1.67, SD = 0.83). All fathers reported support from their partner (100%) as a facilitator, followed by support from nurses (71.9%). The most frequently reported barrier was lines and tubes on their neonate (46.9%), followed by work/job commitments (34.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Support from healthcare professionals, psychologists and peers can increase father's involvement in their neonate's care in SNICU.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"747-758"},"PeriodicalIF":1.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-Linked Hypophosphataemia and Burosumab: A Systemic Disease With a New Treatment","authors":"Jessica L. Sandy,&nbsp;Andrew Biggin,&nbsp;Aris Siafarikas,&nbsp;Peter J. Simm,&nbsp;Christine P. Rodda,&nbsp;Craig F. Munns","doi":"10.1111/jpc.70015","DOIUrl":"10.1111/jpc.70015","url":null,"abstract":"<p>X linked hypophosphataemia (XLH) is a systemic, chronic condition that significantly impairs quality of life. In XLH, a phosphate regulating endopeptidase homologue X-linked (<i>PHEX</i>) gene mutation leads to excess fibroblast growth factor 23 (FGF23), causing hypophosphataemia and subsequent rickets, lower limb deformity, pain and other sequelae, however there are likely other non-FGF23 mediated mechanisms contributing to disease. Burosumab is an FGF23 inhibiting monoclonal antibody that has been shown to be significantly more effective in treating X linked hypophosphataemia than previously available treatment (“conventional therapy” with oral phosphate and active vitamin D). Clinical trials and real-world studies have shown that burosumab can improve lower limb deformity, growth, pain, exercise capacity, biochemistry, rickets, and quality of life. However, the full effect of burosumab on the lives of individuals with X linked hypophosphataemia is yet to be determined. How burosumab may impact some of the lesser understood clinical features, including dental abscesses, craniosynostosis, enthesopathy, and osteoarthritis, is unclear. Whether burosumab mitigates the risk of complications associated with conventional therapy (nephrocalcinosis and hyperparathyroidism) has also not been established. There are conflicting recommendations on who should receive burosumab, when they should start it, and for how long they should continue taking it. This review summarises what is known, and more importantly what is unknown, about burosumab use in X linked hypophosphataemia. We highlight important areas for future research to better understand the impact of burosumab in XLH, improve management of XLH, assess cost benefit of, and advocate for fair and equitable access to burosumab.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 5","pages":"685-700"},"PeriodicalIF":1.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoid Osteoma Presenting With Unilateral Leg Wasting","authors":"Amelia Yeoh,&nbsp;Sharon Ng,&nbsp;Adambarage Chandima De Alwis","doi":"10.1111/jpc.70023","DOIUrl":"10.1111/jpc.70023","url":null,"abstract":"&lt;p&gt;Osteoid osteomas are uncommon in children and are typically seen in the second and third decades of life [&lt;span&gt;1&lt;/span&gt;]. We present a toddler presenting with unilateral leg wasting who was eventually found to have an osteoid osteoma.&lt;/p&gt;&lt;p&gt;A previously well 3-year-old boy was referred to the paediatric clinic at a regional hospital due to an intermittent limp which his parents reported had been present since starting to walk at 1 year. There was no history of trauma, and he was systemically well. On examination, he could walk and run with no convincing gait disturbance. His right calf appeared wasted and measured 1 cm thinner than the left. There was no leg length discrepancy or joint irritability. He had normal deep tendon reflexes (DTR) and down-going plantars. Our initial differential diagnosis included hip or spinal pathology and peripheral neuropathy causing unilateral leg atrophy. X-ray revealed a lucent lesion in the right distal tibia with periosteal reaction (Figure 1), which we suspected could be chronic osteomyelitis or Langerhans cell histiocytosis. Blood tests revealed unremarkable inflammatory markers and negative blood culture. CT showed a 9 mm circumscribed lytic lesion (nidus) within the lateral cortex of the right distal tibia (Figure 1).&lt;/p&gt;&lt;p&gt;He was discussed with the orthopaedics team at a tertiary paediatric centre and transferred with the presumptive diagnosis of chronic osteomyelitis on IV cefazolin. MRI showed a cortical-based lesion with extensive marrow inflammation and surrounding soft tissue inflammatory changes. Fluoroscopic guided debridement and biopsy were performed. Histology confirmed an osteoblastic lesion favouring the diagnosis of an osteoid osteoma. He was discharged on oral antibiotics, managed in a Controlled Ankle Motion (CAM) boot to mitigate the risk of pathological fracture, and had complete resolution of symptoms on subsequent follow-up.&lt;/p&gt;&lt;p&gt;Osteoid osteomas account for 10% of benign bone tumours [&lt;span&gt;2&lt;/span&gt;], commonly affecting long bones such as the femur or tibia [&lt;span&gt;1, 3&lt;/span&gt;] It is rare in children &lt; 3 years, and non-specific symptoms tend to delay diagnosis [&lt;span&gt;1, 3&lt;/span&gt;]. Presenting complaints include gait disturbance and nocturnal pain that responds to simple analgesia [&lt;span&gt;1&lt;/span&gt;]. Hsich et al. [&lt;span&gt;3&lt;/span&gt;] reported two patients with lower limb osteoid osteoma presenting with focal neurologic signs including atrophy, weakness, and reduced DTR due to affected limb disuse. CT is most reliable in showing the focal lucent nidus and surrounding reactive sclerosis, which may not be seen on x-ray or MRI [&lt;span&gt;1, 2&lt;/span&gt;]. Osteoid osteomas have been reported to spontaneously resolve; however, treatment traditionally involves surgical resection or radiofrequency ablation [&lt;span&gt;1, 2, 4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Our case highlights osteoid osteoma as a rare but treatable differential in toddlers presenting with chronic gait disturbance and muscle wasting.&lt;/p&gt;&lt;p&gt;The authors declar","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":"61 4","pages":"657-658"},"PeriodicalIF":1.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jpc.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}