'The psychological problem is looking at you, are you looking for it?': psychological associations with symptomatic musculoskeletal referrals.

It is important that paediatric orthopaedic surgeons recognise that psychological conditions may present with musculoskeletal symptoms. Identification through careful and sensitive history taking is vital. There is a lack of training in this regard in paediatric orthopaedics. We present a series of cases initially referred for a musculoskeletal complaint. Further probing revealed an underlying psychological problem which was neither picked up by the referring physician nor volunteered by the patient. In our opinion, it is important that this training omission is addressed as such psychological problems may be devastating for these individuals and their families.