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Critical Diagnoses to Consider in the Assessment of Pediatric Patients Presenting with Limp in the Rheumatology Ward:
Abdolreza Malek1,2, Atefeh Esmati1, Abdolkarim Hamedi1,2
1Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Pediatric limping often has benign causes like transient synovitis, but serious conditions including leukemia and bone tumors also present as childhood limps. Early diagnosis is key for effective treatment of pediatric limping.
Area of Science:
- Pediatric Rheumatology
- Pediatric Orthopedics
- Pediatric Oncology
Background:
- Limping is a common pediatric complaint presenting to emergency departments.
- Causes range from benign musculoskeletal issues to severe conditions like infections and malignancy.
Purpose of the Study:
- To evaluate the causes of limping in children referred to a pediatric rheumatology ward in northeast Iran.
- To analyze clinical, demographic, and paraclinical findings associated with pediatric limping.
Main Methods:
- Cross-sectional study of 95 pediatric patients with limping.
- Data collection included clinical characteristics, demographics, laboratory tests, and paraclinical findings.
- Statistical analysis performed using SPSS version 23.
Main Results:
- Transient synovitis was the most frequent cause (43.1%), followed by reactive arthritis (15.7%).
- Acute lymphocytic leukemia (ALL) accounted for 6% of cases.
- Bone tumors (benign and malignant) represented 4.2% of limping causes.
Conclusions:
- While most childhood limps are benign, non-musculoskeletal causes must be considered.
- Infections of joints and bones are important differential diagnoses for pediatric limping.
Objectives:
Limping is a frequent reason for visits to emergency departments. The causes of limping in children are various, ranging from benign musculoskeletal problems to serious etiologies, such as malignancy and infections.
Methods:
In this recent cross-sectional study, we evaluated the causes of limps in children referred to the pediatric rheumatology ward in northeast Iran. We collected clinical characteristics and demo-graphic data of patients with musculoskeletal limping and documented laboratory tests and other para-clinical findings. Statistical analysis was performed in SPSS software (version 23). A P-value < 0.05 was concluded to be statistically significant.
Results:
Our study investigated 95 pediatric patients with limping referred to the rheumatology department, the majority of whom exhibited acute-onset limping (≤2 days). The most common reason for hospitalization in the rheumatology ward was transient synovitis (43.1%), followed by other causes of reactive arthritis (15.7%). Acute lymphocytic leukemia (ALL) accounted for limping in 6% of the patients, while benign and malignant bone tumors, including osteoid osteoma, osteosarcoma, and Ewing sarcoma, contributed to limping in 4.2% of cases.
Conclusion:
While the cause of limping in children is mostly benign, it is crucial to recognize that the causes may not solely stem from musculoskeletal problems. In instances where the musculoskeletal sys-tem is involved, infections of the joints and bones should also be considered.
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