Evaluation of a limping child

Summary 

Limping is a common symptom in children and may be associated with serious underlying pathology such as musculoskeletal sepsis, malignancy and inflammatory disease. Such conditions require prompt clinical evaluation to guide appropriate investigations and further management, and thereby minimize the impact of the disease. In other situations, limping may be the result of an innocent, self-limiting process within the developmental range of normal. It is equally important to recognize this by a thorough understanding of age appropriate normal gait patterns in order to minimize unnecessary intervention.

In this article, a structured approach to the evaluation of the limping child is presented with an overview of the very large differential diagnoses. We have highlighted those presenting features, which should alert the clinician to likely sinister pathology (‘red flags’), and possible pitfalls in establishing the correct diagnosis.

Keywords: Limping, Gait, Musculoskeletal