Incidence of and Risk Factors for Lower Extremity Apophysitis in Children and Adolescents
Bibliographic record
Abstract
INTRODUCTION: Apophysitis is a common musculoskeletal injury in children and adolescents often resulting in pain and deformity such as bony prominences in Osgood-Schlatter, leading to reduced physical function. A concerning consequence of lower extremity (LE) apophysitis is its potential to reduce physical activity. OBJECTIVES: We aimed to describe the incidence of lower extremity apophysitis in children and estimate the association of leisure-time sport (LT-sport) participation and physical education (PE) on apophysitis incidence. METHODS: In a 5.5-year prospective cohort study of primary-school students, parents sent weekly text messages reporting injury occurrences and LT-sport participation data in the participating children. Injury reports triggered subsequent clinical evaluation. RESULTS: We analyzed data from 878 girls and 792 boys and identified 1265 episodes of apophysitis in 1670 children. Sever's, Sinding-Larsen-Johansson's, and Osgood-Schlatter's diseases constituted more than 99% of LE-apophysitis cases. The median time of injury duration was 3-4 weeks, and the range was between 1 and 45 weeks. The incidence was between 3.2 and 7.0 cases of LE apophysitis per 1000 LT-sport participations. Extra physical education did not increase the risk of apophysitis, whereas children who participated in soccer, handball, basketball, and jump gymnastics were at increased risk (risk ratio [RR] = 2.07-2.74). CONCLUSIONS: Lower extremity apophysitis can result in months of pain. This is important as prolonged periods of injury could reduce LT-sport and exercise participation, thereby decreasing health-related physical activity in childhood. Our results suggest early diagnosis and activity modification in children and adolescents with apophysitis may reduce injury duration, but future intervention studies are required before more definitive causal conclusions can be drawn. TRIAL REGISTRATION: Danish Data Protection Agency (J. no. 2008-41-2240) and ClinicalTrials.gov (NCT03510494).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".