Persistent joint pain, swelling and stiffness in a child should prompt assessment for inflammatory arthritis, with joint count, symmetry and systemic features helping define subtype. Systemic juvenile idiopathic arthritis, macrophage activation syndrome, enthesitis and silent anterior uveitis carry distinct implications for escalation and multidisciplinary care.

Paediatric and trauma-and-orthopaedic clinicians get a focused review of recurrent fractures after minimal trauma. Blue-grey sclera, joint hypermobility, short stature, dental fragility, bone deformity and hearing loss support recognition of a type 1 collagen disorder requiring coordinated multidisciplinary care.

Paediatric, adolescent-health and orthopaedic clinicians get a focused review of activity-related anterior knee pain. A tender tibial tuberosity lump and pain with resisted knee extension support the diagnosis, while activity modification, ice, anti-inflammatory analgesia and later physiotherapy guide management.

Paediatric, orthopaedic and genetics teams get a focused review of FGFR3-related achondroplasia. Disproportionate short stature, proximal limb shortening and characteristic craniofacial features are connected to surveillance for foramen magnum stenosis, hydrocephalus, obstructive sleep apnoea, recurrent middle-ear disease and spinal complications.

Paediatric, endocrine and orthopaedic clinicians get a focused review of defective growth-plate mineralisation. Delayed walking, poor growth, wrist swelling, bowed legs, bone pain and pathological fractures are linked to vitamin D, calcium and phosphate assessment, wrist or knee imaging, supplementation and specialist referral.

Paediatric and orthopaedic clinicians get a focused review of newborn hip screening, acetabular underdevelopment and femoral-head instability. Defined breech presentation or first-degree family history can require ultrasound despite a normal examination, while a true clunk, restricted abduction, asymmetry, limp or delayed walking should prompt imaging and specialist assessment.

Paediatric, neonatal and orthopaedic clinicians get a focused review of abnormal foot positioning at birth. Passive correctability helps distinguish positional talipes from structural clubfoot, while equinovarus features, early Ponseti casting, possible Achilles tenotomy and continued foot-abduction bracing guide treatment and relapse prevention.

Paediatric, oncology and orthopaedic clinicians get a focused review of persistent focal bone pain, night waking, swelling, palpable mass and restricted joint movement. It links very urgent plain radiography with characteristic aggressive bone changes, specialist staging, biopsy, chemotherapy, surgical resection and sarcoma multidisciplinary care.

Paediatric, infectious-diseases and orthopaedic clinicians get a high-stakes review of focal bone pain, limp, reduced limb use and refusal to bear weight. Fever, inflammatory markers and early X-rays may all be reassuring despite infection, so persistent suspicion should lead to cultures, MRI, intravenous antibiotics and surgical review when complications develop.

Paediatric emergency and orthopaedic clinicians get a focused review of slipped upper femoral epiphysis in adolescents with hip, groin, thigh or referred knee pain. A painful limp, external rotation and restricted internal rotation should prompt immediate non-weight-bearing precautions, hip X-rays and urgent orthopaedic assessment.