Genetic causes of chronic musculoskeletal disease in childhood are common.

We surveyed admissions to a pediatric orthopedics hospital for calender years 1957 (polio era) and 1982 (post-polio era). The relative importance of genetic causes of musculoskeletal disease increased after poliomyelitis immunization became universal. Admissions for musculoskeletal disease with a genetic cause (chromosomal, Mendelian, multifactorial, and familial) accounted for 45% of the total in 1957 and 57% in 1982 (p less than 0.02); non-genetic causes were 44% in 1957 and 28% in 1982 (p less than 0.001). The high probability of recurrent disease in the families of these patients implies that genetics has an important place in the provision of services and in the education of staff in pediatric orthopedic hospitals.