Pediatric limp

Written By The Administrator

Traumatic – XR 

  • Atraumatic, no signs of infection – XR, if negative then US hip 

  • Atraumatic, signs of infection – CBC, ESR, CRP; US hip, if negative consider XR, if negative and still concerned for septic arthritis consider MRI

  • S: Septic arthritis (hip>knee)

  • T: Toddler’s fracture (1-3 years, minor fall with rotational component)

  • O: Osteomyelitis (2% of those children presenting with limp)

  • P: Perthes disease (Legg-Calve-Perthes disease, an idiopathic AVN, affecting children 3-12 years old)

  • L: Limb length discrepancy

  • I: Inflammatory (transient synovitis, 3-6 years of age after viral illness)

  • M: Malignancy

  • P: Pyomyositis (possible viral cause such as influenza, often with tender calves)

  • I: Iliopsoas abscess

  • N: Neurologic (stroke, will often have underlying pathology such as cardiac lesion, sickle cell disease, metabolic history; ataxia can present with a reported ‘limp’)

  • G: Gastrointestinal (appendicitis), genitourinary (testicular/ovarian torsion)

The Administrator
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