Differential Diagnosis Limping

Question 1

Common diagnosis before the age of 5 for limping

Answer 1

Osteomyelitis

Hip dysplasia

Septic arthritis

Transient synovitis

Occult fractures

Kohler syndrome

Question 2

Osteomyelitis

Answer 2

Inflammation of the bone due to an infection
Age <5

Question 3

Septic Arthritis

Answer 3

Infection in the joint fluid: More likely with open wound and weakened immune system
Age < 5

Question 4

Hip Dysplasia

Answer 4

Need to look up Age < 5

Question 5

Transient Synovitis

Answer 5

Most common cause of limp
Inflammation of lining of hip joint
Typical after viral infection
Boys> girls
Ages 2-10
Relieved by rest and anti-inflammatories ~3 days

Question 6

Occult Fracture

Answer 6

Fractures not seen on Xray, related to all ages, linked to open physeal plates, imaged by MRI, US

Question 7

Kohler Syndrome

Answer 7

Navicular blood flow obstruction–> avascular necrosis
Typically unilateral
Typically self limiting
4-7 y/o

Question 8

Ages 4-10 common causes of limping

Answer 8

Transient synovitis

Legg-Calve-Perthes disease

Discoid lateral meniscus

Sever disease

Growing pains

Musculoskeletal Injury

Question 9

Legg-Calve-Perthes Disease

Answer 9

Loss of blood flow to femoral head–> Collapse
If ball is no longer round after

Question 10

Discoid Lateral Meniscus

Answer 10

Lateral meniscus is discoid in shape instead of semilunar - knee clicks

Non-operative: immobilize knee, strengthen quads

Question 11

Severs Disease (description, MOI, age range)

Answer 11

Heel pain caused from Achilles tendon pulling on the calcaneal growth plate - overuse is MOI

Age range 8-14 yrs

Question 12

Osteochdritis Dissecans

Answer 12

Cartilage pulls away from bone due to repeated trauma

Question 13

Freiburg Disease

Answer 13

Affects metatarsal bones of foot of active children. Typically affects second metatarsal (head of metatarsal collapses and flattens)