Previously shared in D CEO Magaizine.

How early will a child show signs of having an orthopedic issue that may need medical attention?

DR. DANIEL SUCATO: Orthopedic issues can present as congenital abnormalities of the bones, meaning the bones were not completely or normally formed in utero. This can occur in the spine or the upper and lower extremities. Often these patients do not require treatment early, or sometimes ever, but they should be evaluated to see if treatment is necessary.

DR. PHILIP WILSON: As a pediatric cartilage and ligament surgeon, we often see children with congenital meniscus or cartilage conditions within the knee. Sometimes these can present as early as toddler age, but more often young school-age with a loss of full extension or occasional limp.

What should I expect at our first visit to a pediatric orthopedic specialist?

DR. DANIEL SUCATO: At the initial visit, the family and patient will first meet with the p ovider to discuss the concerns and note any family history regarding the issue. A physical and orthopedic examination will evaluate the areas of con-cern. If necessary, appropriate imaging studies, such as ultrasound, plain radiograph, CT or MRI scan, will follow. Let your child know the imaging studies, if necessary, will not hurt.

DR. PHILIP WILSON: We also make sure the child is directly involved in the discussion. As kids get older, the perception and magnitude may be different for parents than it is for the child. Prior to the visit, parents can help by letting them know we are just going to check their muscles-no shots.

What are common issues in children that fall under the category of "pediatric orthopedics?"

DR. DANIEL SUCATO: Pediatric orthopedics involves anything related to children's muscles, joints or bones, so that would be conditions like clubfoot, scoliosis, developmental hip dysplasia, and even traumatic or sports injuries. We also have subspecialties in spine, upper and lower extremities, foot and ankle, sports injuries, and fractures.

DR. PHILIP WILSON: Within pediatric sports medicine, conditions involving the cartilage or instability of the joint or injuries affecting th tissues around the joint are common reasons for treatment.

Do all orthopedic issues require surgery? What are other forms of treatment?

DR. DANIEL SUCATO: Most can be treated without surgery. Physical therapy can improve range of motion, strength, and flexibilit. Other treatments include bracing, casting, and anti-infla matory medications.

DR. PHILIP WILSON: We always reserve surgery for use when other options are not available. In addition to what Dr. Sucato mentioned, sometimes simple reassurance to the family that the orthopedic condition is normal or will improve with age may be all that is required.