{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:49Z","timestamp":1792787269540,"version":"4.5.0"},"reference-count":43,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Roche Products Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000938","name":"Department of Veterans' Affairs, Australian Government","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100000938","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Merck, Sharp and Dohme (Australia) Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Wyeth Australia Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Janssen-Cilag Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100003921","name":"Department of Health, Australian Government","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"name":"AstraZeneca Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1143435"],"award-info":[{"award-number":["1143435"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Abbott Australasia Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Aventis Pharma Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000948","name":"Pfizer Australia","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100000948","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Bayer Australia Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"bioCSL (Australia) Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100001203","name":"GlaxoSmithKline Australia Pty Ltd","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100001203","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Novartis Pharmaceuticals Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"National Prescribing Service","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"AbbVie Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Sanofi-Aventis Pty Ltd","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,6,30]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore children\u2019s foot, ankle and leg consultation patterns and management practices in Australian primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional, retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Australia Bettering the Evaluation and Care of Health program dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Data were extracted for general practitioners (GPs) and patients\n                      <jats:underline>&lt;<\/jats:underline>\n                      18 years from April 2000 to March 2016 inclusive.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Demographic characteristics: sex, GP age groups (ie, &lt;45, 45\u201354, 55+ years), GP country of training, patient age grouping (0\u20134, 5\u20139, 10\u201314, 15\u201318 years), postcode, concession card status, indigenous status, up to three patient encounter reasons, up to four encounter problems\/diagnoses and the clinical management actioned by the GP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children\u2019s foot, ankle or leg problems were managed at a rate of 2.05 (95% CI 1.99 to 2.11) per 100 encounters during 229\u2009137 GP encounters with children. There was a significant increase in the rate of foot, ankle and leg problems managed per 100 children in the population, from 6.1 (95% CI 5.3 to 6.8) in 2005\u20132006 to 9.0 (95% CI 7.9 to 10.1) in 2015\u20132016. Management of children\u2019s foot, ankle and leg problems were independently associated with male patients (30% more than female), older children (15\u201318 years were 7.1 times more than &lt;1 years), male GPs (13% more) and younger GPs (&lt;45 years of age 13% more than 55+). The top four most frequently managed problems were injuries (755.9 per 100\u2009000 encounters), infections (458.2), dermatological conditions (299.4) and unspecified pain (176.3). The most frequently managed problems differed according to age grouping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children commonly present to GPs for foot, ankle and leg problems. Presentation frequencies varied according to age. Unexpectedly, conditions presenting commonly in adults, but rarely in children, were also frequently recorded. This data highlights the importance of initiatives supporting contemporary primary care knowledge of diagnoses and management of paediatric lower limb problems to minimise childhood burden of disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-062063","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T01:58:14Z","timestamp":1658973494000},"page":"e062063","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Australian children\u2019s foot, ankle and leg problems in primary care: a secondary analysis of the Bettering the Evaluation and Care of Health (BEACH) data"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0223-9141","authenticated-orcid":false,"given":"Cylie M","family":"Williams","sequence":"first","affiliation":[{"name":"School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hylton B","family":"Menz","sequence":"additional","affiliation":[{"name":"Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Lazzarini","sequence":"additional","affiliation":[{"name":"School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia"},{"name":"Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Gordon","sequence":"additional","affiliation":[{"name":"WHO-CC for Strengthening Rehabilitation Capacity in Health Systems, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8769-6877","authenticated-orcid":false,"given":"Christopher","family":"Harrison","sequence":"additional","affiliation":[{"name":"Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, Parramatta, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"2025121407482819000_12.7.e062063.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-2126"},{"key":"2025121407482819000_12.7.e062063.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.6.e84"},{"key":"2025121407482819000_12.7.e062063.3","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/JSM.0000000000000925","article-title":"Describing frequencies of lower-limb Apophyseal injuries in children and adolescents: a systematic review","volume":"32","author":"Haines","year":"2022","journal-title":"Clin J Sport Med"},{"key":"2025121407482819000_12.7.e062063.4","unstructured":"World Health Organization . Guidelines on the management of chronic pain in children, 2020."},{"key":"2025121407482819000_12.7.e062063.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-035965"},{"key":"2025121407482819000_12.7.e062063.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.10444"},{"key":"2025121407482819000_12.7.e062063.7","unstructured":"National Collaborating Centre for Cancer . Suspected cancer: recognition and referral, 2015."},{"key":"2025121407482819000_12.7.e062063.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-014-0652-8"},{"key":"2025121407482819000_12.7.e062063.9","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdu079"},{"key":"2025121407482819000_12.7.e062063.10","unstructured":"Australian Government . Health and disability, Canberra. services Australia, 2021. Available: https:\/\/www.servicesaustralia.gov.au\/health-and-disability"},{"key":"2025121407482819000_12.7.e062063.11","unstructured":"Services Australia . Medicare - What\u2019s covered, Cancerra. Australian Government, 2021. Available: https:\/\/www.servicesaustralia.gov.au\/whats-covered-medicare?context=60092"},{"key":"2025121407482819000_12.7.e062063.12","doi-asserted-by":"crossref","unstructured":"Menz HB , Williams CM , Lazzarini PA , et al . Foot, ankle, and leg problems in Australian primary care: consultation patterns, management practices and costs 2022.","DOI":"10.21203\/rs.3.rs-1322389\/v1"},{"key":"2025121407482819000_12.7.e062063.13","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2003.028860"},{"key":"2025121407482819000_12.7.e062063.14","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-216"},{"key":"2025121407482819000_12.7.e062063.15","doi-asserted-by":"crossref","first-page":"e428","DOI":"10.1093\/pubmed\/fdz141","article-title":"Musculoskeletal consultations from childhood to adulthood: a longitudinal study","volume":"42","author":"Prathivadi Bhayankaram","year":"2020","journal-title":"J Public Health"},{"key":"2025121407482819000_12.7.e062063.16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12891-018-1952-7","article-title":"Epidemiology of paediatric presentations with musculoskeletal problems in primary care","volume":"19","author":"Tan","year":"2018","journal-title":"BMC Musculoskelet Disord"},{"key":"2025121407482819000_12.7.e062063.17","first-page":"411","article-title":"Beach program update","volume":"44","author":"Britt","year":"2015","journal-title":"Aust Fam Physician"},{"key":"2025121407482819000_12.7.e062063.18","unstructured":"Family Medicine Research Centre . CAPS - Coding Atlas for Pharmaceutical Substances, Bettering the Evaluation and Care of Health (BEACH); 2018. Available: http:\/\/sydney.edu.au\/medicine\/fmrc\/caps\/index.php"},{"key":"2025121407482819000_12.7.e062063.19","unstructured":"World Health Organization Collaborating Centre for Drug Statistics Methodology . Anatomical therapeutic chemical classification index with defined daily doses. Oslo: World Health Organization, 2009."},{"key":"2025121407482819000_12.7.e062063.20","first-page":"S79","article-title":"A new coding tool for computerised clinical systems in primary care--ICPC plus","volume":"26 Suppl 2","author":"Britt","year":"1997","journal-title":"Aust Fam Physician"},{"key":"2025121407482819000_12.7.e062063.21","unstructured":"Classification Committee of the World Organization of Family Doctors (WICC) . ICPC-2: International classification of primary care. Geneva: World Health Organization, 1998."},{"key":"2025121407482819000_12.7.e062063.22","unstructured":"World Health Organisation . ICD-10: international statistical classification of diseases and related health problems. Geneva: World Health Organisation, 2004."},{"key":"2025121407482819000_12.7.e062063.23","unstructured":"Australian Bureau of Statistics . Australian demographic statistics, Sep 2008 (3101.0). Canberra: Australian Bureau of Statistics, 2009."},{"key":"2025121407482819000_12.7.e062063.24","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.125015"},{"key":"2025121407482819000_12.7.e062063.25","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1136\/bmj.318.7184.642","article-title":"Socioeconomic differences in childhood consultation rates in general practice in England and Wales: prospective cohort study","volume":"318","author":"Saxena","year":"1999","journal-title":"BMJ"},{"key":"2025121407482819000_12.7.e062063.26","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-8-1"},{"key":"2025121407482819000_12.7.e062063.27","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s10140-008-0733-2","article-title":"Commonly missed subtle skeletal injuries in children: a pictorial review","volume":"15","author":"Jadhav","year":"2008","journal-title":"Emerg Radiol"},{"key":"2025121407482819000_12.7.e062063.28","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.aap.2018.05.019","article-title":"Bicycle-related injuries among children treated in US emergency departments, 2006-2015","volume":"118","author":"McAdams","year":"2018","journal-title":"Accid Anal Prev"},{"key":"2025121407482819000_12.7.e062063.29","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/sms.12981","article-title":"Risk factors for football injuries in young players aged 7 to 12\u00a0years","volume":"28","author":"R\u00f6ssler","year":"2018","journal-title":"Scand J Med Sci Sports"},{"key":"2025121407482819000_12.7.e062063.30","doi-asserted-by":"crossref","first-page":"939","DOI":"10.3233\/BMR-181436","article-title":"A cross-sectional study on foot loading patterns in elite soccer players of different ages","volume":"33","author":"Hotfiel","year":"2020","journal-title":"J Back Musculoskelet Rehabil"},{"key":"2025121407482819000_12.7.e062063.31","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s43465-020-00270-9","article-title":"Paediatric ankle fractures: guidelines to management","volume":"55","author":"Venkatadass","year":"2021","journal-title":"Indian J Orthop"},{"key":"2025121407482819000_12.7.e062063.32","unstructured":"Therapeutic Guidelines [digital] . Melbourne: therapeutic guidelines limited, 2021. Available: https:\/\/tgldcdp.tg.org.au\/etgcomplete"},{"key":"2025121407482819000_12.7.e062063.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.07.016"},{"key":"2025121407482819000_12.7.e062063.34","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199907001-00008"},{"key":"2025121407482819000_12.7.e062063.35","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.pmr.2007.11.003","article-title":"Common injuries of the foot and ankle in the child and adolescent athlete","volume":"19","author":"Malanga","year":"2008","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"2025121407482819000_12.7.e062063.36","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.berh.2016.08.005","article-title":"Models of care for addressing chronic musculoskeletal pain and health in children and adolescents","volume":"30","author":"Stinson","year":"2016","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025121407482819000_12.7.e062063.37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12969-020-00451-8","article-title":"The paediatric global musculoskeletal task force - \u2018towards better MSK health for all\u2019","volume":"18","author":"Foster","year":"2020","journal-title":"Pediatr Rheumatol"},{"key":"2025121407482819000_12.7.e062063.38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1546-0096-11-44","article-title":"pGALS \u2013 paediatric gait arms legs and spine: a simple examination of the musculoskeletal system","volume":"11","author":"Foster","year":"2013","journal-title":"Pediatric Rheumatology"},{"key":"2025121407482819000_12.7.e062063.39","unstructured":"Newcastle University and Northumbria University . Paediatric musculoskeletal matters International (pmm), 2022. Available: https:\/\/www.pmmonline.org\/doctor"},{"key":"2025121407482819000_12.7.e062063.40","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s10067-019-04544-y","article-title":"A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education","volume":"39","author":"Al Maini","year":"2020","journal-title":"Clin Rheumatol"},{"key":"2025121407482819000_12.7.e062063.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.08.013"},{"key":"2025121407482819000_12.7.e062063.42","first-page":"338","article-title":"Awareness of common paediatric orthopaedic problems among paediatricians and family medicine physicians","volume":"13","author":"Fallatah","year":"2018","journal-title":"J Taibah Univ Med Sci"},{"key":"2025121407482819000_12.7.e062063.43","unstructured":"Department of Health . VOPN paediatric orthopaedic referral guidelines, Melbourne. Victorian Governement, 2015. Available: https:\/\/www.health.vic.gov.au\/patient-care\/referrals-to-specialist-paediatric-orthopaedic-services"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-062063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:48:46Z","timestamp":1765727326000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-062063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,27]]},"published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1136\/bmjopen-2022-062063"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-062063","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2022.02.12.22270840","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}