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Published on: June 12, 2009
The limping child: a systematic approach to diagnosis
Jeffrey R Sawyer1, Mukesh Kapoor
1University of Tennessee-Campbell Clinic, LeBonheur Children's Medical Center, Memphis, Tennessee 38104, USA. jsawyer@campbellclinic.com
American Family Physician
|February 11, 2009
Summary
Limping in children often stems from minor injuries but can signal serious conditions. Prompt diagnosis through history, physical exam, and tests is crucial to prevent severe outcomes.
Area of Science:
- Pediatrics
- Orthopedics
- Gait Analysis
Background:
- Limping in children can result from various causes, ranging from minor injuries to severe, life-threatening conditions.
- Delayed diagnosis and treatment of pediatric limping can lead to significant morbidity and mortality.
Purpose of the Study:
- To outline a diagnostic approach for evaluating limping children.
- To emphasize the importance of a thorough history and physical examination in identifying the underlying cause of a limp.
Main Methods:
- Gathering a detailed patient history, focusing on pain, trauma, and systemic symptoms.
- Performing a comprehensive physical examination to identify limp type and localize pathology.
- Utilizing laboratory tests and imaging studies to confirm diagnoses.
Main Results:
- Systemic symptoms like fever, night sweats, weight loss, and anorexia may indicate infection, inflammation, or malignancy.
- Localized tenderness or palpable masses during examination can suggest fractures, osteomyelitis, or malignancy.
- Non-musculoskeletal conditions should also be considered in the differential diagnosis.
Conclusions:
- A systematic approach combining history, physical examination, and targeted investigations is essential for diagnosing the cause of limping in children.
- Early and accurate diagnosis is critical to ensure appropriate management and prevent long-term complications.
