Limp

Question 1

What aetiologies would you consider for a limp in:

• toddler (1-4y)
• child (4-10y)
• adolescent (>10y)

Answer 1

Toddler (1-4 years)
• Developmental dysplasia of the hip (DDH)
• Toddlers fracture
• Transient synovitisof the hip (Irritable hip)
• Child abuse

Child (4-10 years)
• Transient synovitisof the hip
• Perthes Disease

Adolescent (>10 years)
• Slipped upper femoral epiphysis (SUFE)
• Overuse syndromes / stress fractures

Question 2

List some aetiologies that you should consider for a limp at all ages.

Answer 2

• Infections:Osteomyelitis / Septic Arthritis, discitis, soft tissue, viral myositis
• Trauma/ non-accidental
• Malignancy - ALL, bone
• Rheumatological disorders and reactive arthritis
• Intra-abdominal pathology, eg: appendicitis
• Inguinoscrotal disorders, eg: testicular torsion
• Vasculitis, serum sickness
• Functional limp

Question 3

What may lateral thigh pain indicate in the setting of a limp?

Answer 3

lumbar spine abnormality (e.g. discitis, ruptured lumbar disc, vertebral osteomyelitis)

Question 4

Where does hip pain often refer to?

Answer 4

The hip e.g. SUFE/Perthe’s