Obesity-Induced Joint Stress and Inflammation in Children: A Narrative Review on the Early Origins of Osteoarthritis

Document Type : review article

Author

Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.

10.22038/jpp.2025.90013.5587

Abstract

Background: Childhood obesity is emerging as a global health crisis with associated comorbidities. Musculoskeletal complaints in children are one of these comorbidities, with early-onset osteoarthritis (OA) gaining recognition. Early-onset OA in the pediatric population remains underdiagnosed due to the lack of specific diagnostic criteria and overlap with juvenile arthritis symptoms.
Aim: This review aims to explore the most recent evidence regarding early-onset osteoarthritis in obese children, particularly in the knee, highlighting correlations between imaging, biomechanics, and inflammation.
Methods: This narrative review compiles current evidence from imaging, inflammatory biomarkers, clinical, and biomechanical studies to evaluate early degenerative joint changes observed in obese children. Specific keywords were used to collect relevant literature from PubMed and other sources , which were added to Zotero.
Results: Imaging modalities such as Magnetic Resonance Imaging (MRI) and ultrasound showed joint alterations in obese children similar to the early changes seen in adult-onset osteoarthritis. Elevated levels of adipokines, such as leptin, were correlated with these findings. Children who are affected may present with anterior knee pain and limited function, reducing their quality of life.
Conclusion: Mechanical overload and metabolic inflammation in obese children lead to joint degeneration, presenting as a distinct pathology. Diagnosis and intervention are essential to prevent progression to irreversible OA in adults. A refined pediatric diagnostic criterion is needed; this can be accomplished by increasing clinician recognition of the disease in this age group, imaging-guided evaluation, and further longitudinal studies.

Keywords

References

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Journal of Pediatric Perspectives
Volume 13, Issue 9
September 2025
Pages 19669-19685

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