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Congenital insensitivity to pain in a child attending a paediatric fracture clinic

Abdulla, Mohameda; Khaled, Sari S.a; Khaled, Yazan S.a,b,c; Kapoor, Harisha

Journal of Pediatric Orthopaedics B: September 2014 - Volume 23 - Issue 5 - p 406–410
doi: 10.1097/BPB.0000000000000051
Foot & Ankle

Congenital insensitivity to pain is a rare condition that is often undiagnosed until patients present with a variety of musculoskeletal problems. A major sequel of these orthopaedic manifestations is the development of heterotopic ossification and callus formation following fractures, eventually leading to the development of a Charcot’s joint. This case reports on a 7-year-old child who was diagnosed with congenital insensitivity to pain type V, after he presented in our clinic with fractures of the metatarsals in his left foot while continuing to weight bear, without any discomfort. The patient failed to attend the follow-up in paediatric neurology clinic despite multiple invitations. This case highlights the importance of establishing an early diagnosis and keeping a close eye on this rare entity, which can present for the first time in a paediatric fracture clinic.

aDepartment of Trauma and Orthopaedic Surgery at Leeds General Infirmary

bThe University of Leeds

cSection of Translational Anaesthetic and Surgical Sciences, Leeds Institute of Molecular Medicine, Leeds, UK

Correspondence to Harish Kapoor, FRCS, MD, Department of Trauma and Orthopaedic Surgeon, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK Tel: +44 113 243 2799; fax: +44 113 243 7922; e-mail: kapoorh@hotmail.com

© 2014 by Lippincott Williams & Wilkins, Inc.