Skip to main content
SpringerLink
Log in

The Limping Child

  • Chapter
  • First Online:
Children's Orthopaedics and Fractures

  • 2711 Accesses

Abstract

Evaluating a limp in a growing child is a problem often faced by paediatricians, accident and emergency department doctors, general practitioners, and orthopaedic surgeons. There are many causes, ranging from surgical emergencies to children who need observation only [1]. It is often not possible to know with certainty how serious the condition is at the initial examination, and so it is important to adopt a systematic approach to evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Cloth bound cover Book
USD 169.99
Price excludes VAT (USA)
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lawrence LL. The limping child. Emerg Med Clin North Am 1998; 16:4:911–929.

    Article  PubMed  CAS  Google Scholar 

  2. Fischer SU, Beattie TF. The limping child: Epidemiology, Assessment and Outcome. J Bone Joint Surg 1999; 81B 1029–1034.

    Article  Google Scholar 

  3. Hensinger RN. Limp. Pediatr Clin North Am 1986; 33: 6:1355–1362.

    PubMed  CAS  Google Scholar 

  4. Sutherland D. The development of mature gait. Gait Posture 1997; 6:163–170.

    Article  Google Scholar 

  5. Dabney KW, Lipton G. Evaluation of limp in children. Curr Opinion Pediat 1995; 7:88–94.

    Article  CAS  Google Scholar 

  6. Phillips WA. The child with a limp. Orthop Clin North Am 1987; 18:4:489–501.

    PubMed  CAS  Google Scholar 

  7. Renshaw TS. The child who has a limp. Pediatr Rev 1995; 16: 12:458–465.

    PubMed  CAS  Google Scholar 

  8. Huttenlocher A, Newman TB. Evaluation of the erythrocyte sedimentation rate in children presenting with limp, fever or abdominal pain. Clin Pediatr 1997; 339–344.

    Google Scholar 

  9. Unkila-Kallio L, Kallio MJT, Eskola J, Peltola, H. Serum C-reactive protein, erythrocyte sedimentation rate and white blood cell count in acute hematogenous osteomyelitis of children. Pediatrics 1994; 93:59–62.

    PubMed  CAS  Google Scholar 

  10. Myers MT, Thompson GH. Imaging the child with a limp. Pediatr Clin North Am 1997; 44:3:637–658.

    Article  Google Scholar 

  11. Blatt SD, Rosenthal BM, Barnhart, DC. Diagnostic utility of lower extremity radiographs of young children with gait disturbance. Pediatrics 1991; 87:138–140.

    PubMed  CAS  Google Scholar 

  12. Connolly LP, Treves ST. Assessing the limping child with skeletal scintigraphy. J Nucl Med. 1998; 39:6:1056–1061.

    PubMed  CAS  Google Scholar 

  13. Aronson J, Garvin K, Seibert J, et al. Efficiency of the bone scan for occult limping toddlers. J Pediatr Orthop 1992; 12:38–44.

    PubMed  CAS  Google Scholar 

  14. Pennington WT, Mott MP, Thometz JG, et al. Photopenic bone scan osteomyelitis: a clinical perspective. J Pediatr Orthop 1999; 19:695–698.

    PubMed  CAS  Google Scholar 

  15. Terjesen T, Osthus P. Ultrasound in the diagnosis and follow-up of transient synovitis of the hip. J Pediatr Orthop 1991; 11:608–613.

    PubMed  CAS  Google Scholar 

  16. Choban S, Killian JT. Evaluation of acute gait abnormalities in preschool children. J Pediatr Orthop 1990; 10:74–78.

    PubMed  CAS  Google Scholar 

  17. Ogden JA. Skeletal Injury in a Child. Philadelphia: Lee & Febiger. 1982.

    Google Scholar 

  18. Walker RN, Green NE, Spindler KP. Stress fractures in skeletally immature patients. J Pediatr Orthop 1996; 16:578–584.

    Article  PubMed  CAS  Google Scholar 

  19. Lombardo SJ, Retting AC, Lerlan RK. Radiographic abnormalities of the iliac apophysis in adolescent athletes. J Bone Joint Surg 1983; 65A:444–455.

    Google Scholar 

  20. Bickerstaff DR, Neal LM, Brennan PO. An investigation into the etiology or irritable hip. Clin Pediatr 1991; 30:6:353–356.

    Article  CAS  Google Scholar 

  21. Landin LA, Danielsson LG, Wattsgard C. Transient synovitis of the hip. J Bone Joint Surg 1987; 69B:238–242.

    Google Scholar 

  22. Illingworth CM. Recurrences of transient synovitis. Arch Dis Child 1983; 58:620–623.

    Article  PubMed  CAS  Google Scholar 

  23. Haueisen DC, Weiner SD. The characterization of “transient synovitis of the hip” in children. J Pediatr Orthop 1986; 6:11–17.

    Article  PubMed  CAS  Google Scholar 

  24. Sharwood PF. The irritable hip syndrome in children. Acta Orthop Scan 1981; 52:633–638.

    Article  CAS  Google Scholar 

  25. DeValderrama JAP. The “observation hip” syndrome and its late sequelae. J Bone Joint Surg. 1963; 45B:462–470.

    Google Scholar 

  26. Winstrand H. Transient synovitis of the hip in the child. Acta Orthop Scand Suppl. 1986; 57:219.

    Google Scholar 

  27. Kallio P, Ryoppy S, Kunnamo I. Transient synovitis and Perthes disease. J Bone Joint Surg 1986; 68B:808–811.

    Google Scholar 

  28. DelBeccaro MA, Campoux AN, Bockers T, Mendelman, PM. Septic arthritis versus transient synovitis of the hip: the value of screening laboratory tests. Ann Emerg Med 1992; 21:1418–1422.

    Article  CAS  Google Scholar 

  29. Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence based clinical prediction algorithm. J Bone Joint Surg 1999; 81A:1662–1670.

    Google Scholar 

  30. Birdi N, Allen U, D’ Astous J. Poststreptococcal reactive arthritis mimicking acute septic arthritis: a hospital-based study. J Pediatr Orthop 1995; 15:661–665.

    Article  PubMed  CAS  Google Scholar 

  31. Scott, RJ, Christofersen, MR, Robertson WW, Davidson RS, Rankin L, Drummond DS. Acute osteomyelitis in children: a review of 116 cases. J Pediatr Orthop 1990; 10:649–652.

    Article  PubMed  CAS  Google Scholar 

  32. Mustafa MM, Saez-Llorens X, McCracken GH, Nelson JD. Acute hematogenous pelvic osteomyelitis in infants and children. Pediatr Infect Dis J 1990; 9:6:416–421.

    Article  PubMed  CAS  Google Scholar 

  33. Perlman MH, Patzakis MJ, Jumar PI, Holtom P. The incidence of joint involvement with adjacent osteomyelitis in pediatric patients. Pediatr Orthop 2000; 20:40–43.

    CAS  Google Scholar 

  34. Viani RM, Bromberg K, Bradley JS. Obturator internus muscle abscess in children: report of seven cases and review. Clin Infect Dis 1999; 28:117–122.

    Article  PubMed  CAS  Google Scholar 

  35. Lyon RM, Evanich JD. Culture-negative septic arthritis in children. J Pediatr Orthop 1999; 19:655–659.

    PubMed  CAS  Google Scholar 

  36. Ring D, Johnson CE, Wenger DR. Pyogenic infectious spondylitis in children: the convergence of discitis and vertebral osteomyelitis. J Pediatr Orthop 1995; 15:652–660.

    Article  PubMed  CAS  Google Scholar 

  37. Hollingworth P. Differential diagnosis and management of hip pain in childhood. Br J Rheumatol 1995; 34:78–82.

    Article  PubMed  CAS  Google Scholar 

  38. Jacobsen FS, Sullivan B. Spinal epidural abscesses in children. Orthopaedics 1994; 17:1131–1138.

    CAS  Google Scholar 

  39. Malhotra R, Singh KD, Bhan S, Dave PK. Primary pyogenic abscess of the psoas muscle. J Bone Joint Surg 1992; 74A:278–284.

    Google Scholar 

  40. Rose CD, Fawcett PT, Eppes SC, et al. Pediatric Lyme arthritis: clinical spectrum and outcome. J Pediatr Orthop 1994; 14:238–241.

    Article  PubMed  CAS  Google Scholar 

  41. Willis A, Widmann R, Flynn J, et al. Lyme arthritis presenting as acute septic arthritis in children. J Pediatr Orthop 2003; 23:114–118.

    PubMed  Google Scholar 

  42. Jacobs RF, McCarthy RE, Elser JM. Pseudomonas Osteochondritis complicating puncture wounds of the foot in children: a ten-year evaluation. J Infect Dis 1989; 160:657–661.

    Article  PubMed  CAS  Google Scholar 

  43. Skaggs DL, Roberts JM, Codsi MJ, et al. Mild gait abnormality and leg discomfort in a child secondary to extradural ganglioneuroma. Am J Orthop 2000; 29:111–114.

    PubMed  CAS  Google Scholar 

  44. Tuten HR, Gabos PG, Kumar SJ, Harter GD. The limping child: a manifestation of acute leukemia. J Pediatr Orthop 1998; 18:625–629.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedics Department, Marshfield Clinic, Marshfield, WI, USA

    F. Stig Jacobsen

  2. Department of Pediatric Surgery, The Queen Silvia Children’s Hospital, Goteborg, Sweden

    Göran Hansson

Authors
  1. F. Stig Jacobsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Göran Hansson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, United Kingdom

    Michael Benson

  2. Sick Children, Great Ormond Street Hospital for, Greater Ormond Street, London, WC1N 3JH, United Kingdom

    John Fixsen

  3. Orthopaedic Hospital, Princess Margaret Rose, Frogston Road West 41-43, Edinburgh, EH10 7ED, United Kingdom

    Malcolm Macnicol

  4. Orthopädie, Olgahospital, Bismarckstr. 8, Stuttgart, 70176, Germany

    Klausdieter Parsch

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag London Limited

About this chapter

Cite this chapter

Stig Jacobsen, F., Hansson, G. (2010). The Limping Child. In: Benson, M., Fixsen, J., Macnicol, M., Parsch, K. (eds) Children's Orthopaedics and Fractures. Springer, London. https://doi.org/10.1007/978-1-84882-611-3_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-611-3_25

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-610-6

  • Online ISBN: 978-1-84882-611-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation