A limp suggests an underlying pathology causing the abnormal gait pattern. There is a long list of possible causes. The challenge for the physician is to identify the cause and act accordingly. The purpose of this article is to instruct on the assessment of a child with a limp.
Aronson J, Garvin K, Seibert J, Glasier C, Tursky EA.1992. Efficiency of the bone scan for occult limping toddlers.J Pediatr Orthop12: 38-44.
2.
Bickerstaff DR, Neal LM, Booth AJ, Brennan PO, Bell MJ.1990. Ultrasound examination of the irritable hip.J Bone Joint Surg Br72: 549-553.
3.
Blatt SD, Rosenthal BM, Barnhart DC.1991. Diagnostic utility of lower extremity radiographs of young children with gait disturbance.Pediatr87: 138-140.
4.
Connolly LP, Treves ST.1998. Assessing the limping child with skeletal scintigraphy.J Nucl Med39: 1056-1061.
5.
Dalton GP, Drummond DS, Davidson RSet al.1996. Bone infarction versus infection in sickle cell disease in children.J Pediatr Orthop16(4): 540-544.
6.
Faden H, Grossi M.1991. Acute osteomyelitis in children: reassessment of etiologic agents and their clinical characteristics.Am J Dis Child145: 65-69.
7.
Fink CW, Nelson JD.1986. Septic arthritis and osteomyelitis in children.Clin Rheum Dis12: 423-435.
8.
Fischer SU, Beattie TF.1999. The limping child: epidemiology, assessment and outcome.J Bone Joint Surg Br81-B(6): 1029-1034.
9.
Jaramillo D, Treves ST, Kasser JR, Harper M, Sundel R, Laor T.1995. Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment.Am J Roentgenol165(2): 399-403.
10.
Kocher MS, Zurakowski D, Kasser JR.1999. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm.J Bone Joint Surg Am81: 1662-1670.
11.
Kocher MS, Mandiga R, Zurakowski D, Barnewolt C, Kasser JR.2004. Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children.J Bone Joint Surg Am86(8): 1629-1635.
12.
Luhmann SJ, Jones A, Schootman Met al.2004. Differentiation between septic arthritis and transient synovitis of the hip in children with clinical prediction algorithms.J Bone Joint Surg Am86(5): 956-962.
13.
McCarthy PL, Wasserman D, Spiesel SZet al.1980. Evaluation of arthritis and arthralgia in the pediatric patient.Clin Pediatr19: 183-190.
14.
Miralles M, Gonzalez G, Pulpeiro JRet al.1989. Sonography of the painful hip in children: 500 consecutive cases.Am J Roentgenol152: 579-582.
15.
Myers MT, Thompson GH.1997. Imaging the child with a limp.Pediatr Clin North Am44: 637-658.
16.
Oudjhane K, Newman B, Oh KS, Young LW, Girdany BR.1988. Occult fractures in preschool children.J Trauma28: 858-860.
17.
Peltola H, Vahvanen V.1984. A comparative study of osteomyelitis and purulent arthritis with special reference to aetiology and recovery.Infection12(2): 75-79.
18.
Scott RJ, Christofersen MR, Robertson WW, Jret al.1990. Acute osteomyelitis in children: a review of 116 cases.J Paediatr Orthop10(5): 649-652.
19.
Song KM, Halliday SE, Little DG.1997. The effect of limb-length discrepancy on gait.J Bone Joint Surg Am79: 1690-1698.
20.
Sonnen GM, Henry NK.1996. Pediatric bone and joint infections: diagnosis and antimicrobial management.Pediatr Clin North Am43: 933-947.
21.
Tuten HR, Gabos PG, Kumar SJet al.1998. The limping child: a manifestation of acute leukemia. J Pediatr Orthop18(5): 625-629.
22.
Walker RN, Green NE, Spindler KP.1996. Stress fractures in skeletally immature patients.J Pediatr Orthop16: 578-584.
