Objective. A retrospective study was conducted in order to point out the di
fferent kinds of musculoskeletal conditions observed in children attending
two Togolese hospitals.
Results. A total of 434 (242 females, 192 males) of the 29 620 children exa
mined (1.5%) were suffering from these conditions. Probable joint and bone
infections (187 patients, 43%), limb deformities (106 patients, 24%), osteo
chondrosis (60 patients, 14%) and vaso-occlusive crisis due to haemoglobino
pathies (29 patients, 7%) were the main conditions observed. Osteomyelitis
observed in 128 patients affected the humerus (25 patients), radius (10 pat
ients), femur (68 patients), tibia (15 patients), fibula (five patients), a
nd both tibia and fibula (five patients). Probably, infectious arthritis se
en in 30 patients affected mainly the hip (11 patients) and the knee (13 pa
tients). In the spine, infection affected the midthoracic and upper lumbar
areas. Underdevelopment, sickle cell anaemia and sickle cell haemoglobin C
disease were the main risk factors in determining susceptibility to infecti
ons. Vaso-occlusive crises were due to sickle cell anaemia (11 patients) an
d sickle cell haemoglobin C disease (18 patients). Osteochondrosis seen in
60 patients free from haemoglobinopathy involved the spine (Scheuermann's d
isease, 38 patients) and the hip (Legg-Calve-Perthes disease, 22 patients).
Limb deformities were observed in the knee (varus and valgus deformities i
n 64 patients) and the foot (talipes varus equin in 40 patients).
Conclusion. This study's findings, which require further confirmation, sugg
est some conclusions. Scheuermann's disease can explain in part the degener
ative disc conditions observed in African adults. Valgus and varus deformit
ies play an important role in the development of knee osteoarthritis in Bla
ck Africa. An African child with joint or bone pain should be investigated
for sickle cell anaemia. In the future, improved lifestyle and better healt
h care will be essential to reduce bone and joint infections, and allow ref
ined diagnosis of connective tissue diseases now probably underestimated in
African children.