Paediatrics_Limp

Question 1

limp causes?

Answer 1

1-4 yrs 
> developmental dysplasia hip
> toddlers fracture
> transient synovitis 
> child abuse 

4-10yrs
> transient synovitis
> perthes disease

Adolescents
Slipped Upper femoral epiphysis

Other: all ages
Infections: Osteomyelitis / Septic Arthritis, discitis, soft tissue, viral myositis

Trauma (see Fractures)

Non accidental or inflicted injury (see Child abuse guideline) - fracture, sprain, haematoma

Malignancy - Acute lymphoblastic leukaemia, bone tumours, eg: spine or long bone

Rheumatological disorders and reactive arthritis

Intra-abdominal pathology, eg: appendicitis

Inguinoscrotal disorders, eg: testicular torsion

Vasculitis, serum sickness

Functional limp

Question 2

1. What is Perthes disease?
2. Which age group does it affect?
3. which % is bilateral?
4. presentation?

Answer 2

1. Avascular necrosis of the capital femoral epiphysis.
2. Age range 2-12 years (majority 4-8yrs)
3. 20% bilateral
4. Present with pain and limp// Restricted hip motion on examination