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Limping in childhood
1Paediatric Orthopaedic Department, University Hospital (A.Z.-V.U.B.), Laarbeeklaan 101, 1090 Brussels, Belgium.
Insights
Limping in children is abnormal and requires diagnosis. A thorough history and physical exam are key to identifying the cause, with further tests guided by these findings.
Area of Science:
- Pediatrics
- Orthopedics
- Gait Analysis
Background:
- Limping is an abnormal gait indicative of underlying issues.
- Causes range from pain and muscular dysfunction to deformities.
- Prompt diagnosis is crucial as limping is never normal.
Purpose of the Study:
- To outline the diagnostic approach for evaluating limping in children.
- To emphasize the importance of clinical assessment in identifying causes of limping.
- To guide the appropriate use of investigations.
Main Methods:
- Comprehensive patient history taking.
- Detailed physical examination of the child.
- Selective use of laboratory tests and imaging based on clinical findings.
Main Results:
- History and physical examination are the primary tools for diagnosis.
- Investigations are guided by initial clinical assessment.
- Some cases may require observation after excluding serious conditions.
Conclusions:
- Establishing the cause of limping is essential.
- Clinical evaluation is paramount in the diagnostic process.
- Observation may be appropriate for idiopathic cases after ruling out pathology.
Abstract:
Limp is an abnormal gait which can be caused by pain, muscular dysfunction or deformity. Limp is never normal and the cause should be established. There is a long list of possible diagnoses. A complete history and thorough physical examination are the most helpful tools in sorting out the various causes of limping. Laboratory tests and imaging studies should be based on findings in the history and physical examination. Certain causes of limping must be diagnosed at the first visit. Sometimes the cause of limping cannot be determined, and after exclusion of any serious disease, the child should be observed. Many of them will have spontaneous resolution without treatment.
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