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toddler injuries? I am thinking her bones may not be right.

Right, this is going to be a bit long winded but need to explain everything. My two year old trapped her finger in the door hinge about 6 months ago, at the time we ran it under the cold tap and a minute later she was fine, so didnt think anything else about it. Then about 6 weeks later we noticed it was still swollen, so we took her to the dr who said nothing to do for it, i didnt really like this answer so we took her to the hospital, where they x-rayed it and said maybe could have been a fracture but healed on its own. that was months ago, but its still a little swollen and still hurts her when I try to bend it. Also her big toe on one foot looks different - we call it a thumb toe or sausage toe its fatter than the others and doesnt bend on its own - when I try to bend it that hurts her too and its causing her to walk differently - she doesnt put her toe on the floor so she walks with a limp (we have been referred to physio for the way she walks but not got a date yet) but I am now wondering if she hurt her toe somehow and the same thing has happened as with her finger and its not healed and she cant use it properly. and thirdly about 3 weeks ago she slipped over and banged her knee - it swelled up so took her to the hospital, they x rayed it and said was just soft tissue damage - but its still got a lump on it and causes her to not be able to walk first thing in a morning as its stiffened up. In my head I am thinking her bones may not be right, or there may be calcium build up on her injuries but dont know how to approach a dr with these symptoms etc.

thanks in advance
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replied November 27th, 2012
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nicola57,

It is usual for a two year old to continue to have problems like this after minor to moderate injuries. Children heal much better than adults and, in almost all cases, do their own therapy through play.

It is concerning that she continues to have swelling in the digits, on both the hand and foot. And now, she has swelling in the knee after falling from a standing height. Small children are always falling down while playing, running, jumping, etc and they do not usually have swelling in the knee afterwards. It is very unusual to see a small child without some bruises on their shins and knees. So, again, it is very uncommon for a child to have swelling in the knee after just banging it from a slip.

Also, the symptom of developing stiffness after a night's rest, is actually a hallmark for an inflammatory disorder.

So, the continued swelling in multiple joints, what you call a "sausage digit", and the morning stiffness, is very concerning for an inflammatory disorder, such as juvenile rheumatoid arthritis (JRA). ("Sausage digit" is actually a term that rheumatologists use to describe the swelling seen in the fingers/toes from some of the inflammatory arthropathies.)


You might want to speak with her pediatrician about the multiple joint problems. Again, the morning stiffness is a classic symptom of JRA, as is the knee swelling. You may have to see a specialist, such as a rheumatologist or orthopedic surgeon. It may be that she is just "clumsy" and has some continuing problems from the traumas, but it would be good to discuss all of these problems with her pediatrician.

Good luck.
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