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Evaluation of the acutely limping child
1University of Southern California School of Medicine, Los Angeles, USA.
American Family Physician
|March 8, 2000
Summary
A limp is an abnormal gait pattern. Identifying the cause requires considering various conditions, patient age, and potential emergencies like septic hip, guiding diagnostic work-up.
Area of Science:
- Pediatrics
- Orthopedics
- Family Medicine
Background:
- A limp is characterized by an asymmetric deviation from a normal gait pattern.
- The differential diagnosis is broad, encompassing trauma, infection, neoplasia, and various disorders.
- Overlooking less common causes like discitis or psoas abscess is a risk.
Purpose of the Study:
- To outline the differential diagnosis of a limp in clinical practice.
- To emphasize considering hip pathology in patients with knee or thigh pain.
- To highlight age-specific conditions and the need for vigilance in emergent cases.
Main Methods:
- Review of common and uncommon causes of limping.
- Emphasis on age-specific differential diagnosis.
- Consideration of referred pain patterns (e.g., hip pain presenting as knee pain).
Main Results:
- A comprehensive differential diagnosis is essential for accurate diagnosis.
- Patient age is a critical factor in narrowing diagnostic possibilities.
- Prompt recognition of emergent conditions like septic hip is crucial.
Conclusions:
- Family physicians must identify the etiology of a limp.
- Determining the need for further observation versus immediate work-up is key.
- A systematic approach considering all potential causes ensures appropriate patient management.