59:
355:
The diagnosis of the cause of a limp is often made based on history, physical exam findings, laboratory tests, and radiological examination. If a limp is associated with pain it should be urgently investigated, while non-painful limps can be approached and investigated more gradually. Young children
165:
The causes of limping are many and can be either serious or non-serious. It usually results from pain, weakness, neuromuscular imbalance, or a skeletal deformity. In 30% of cases, the underlying cause remains unknown after appropriate investigations. The most common underlying cause of limping in
60:
299:
of the hip of unknown cause. People are usually able to walk and may have a low grade fever. They usually look clinically nontoxic or otherwise healthy. It may only be diagnosed once all other potential serious causes are excluded. With symptomatic care it usually resolves over one week.
61:
63:
206:
greater than 2.0 mg/dL, and refusal to walk. People with septic arthritis usually look clinically toxic or sick. Even in the absence of any of these factors, however, septic arthritis may be present. Joint aspiration is required to confirm the diagnosis.
263:. The majority of people affected have a painful limp and in half of cases both hips are affected. Nearly a quarter of people present with only knee pain. Treatment involves non-weight-bearing movement and surgery. If not identified early,
153:, in which the foot is in contact with the ground for a shorter duration than usual; in severe cases there may be a refusal to walk. Hip deformities with associated muscular weakness, on the other hand, may be present with a
537:
Kocher MS, Mandiga R, Zurakowski D, Barnewolt C, Kasser JR (August 2004). "Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children".
716:
612:
Caird MS, Flynn JM, Leung YL, Millman JE, D'Italia JG, Dormans JP (June 2006). "Factors distinguishing septic arthritis from transient synovitis of the hip in children. A prospective study".
62:
360:. SCFE can usually be excluded by an x-ray of the hips. An ultrasound or x-ray guided aspiration of the hip joint maybe required to rule out an infectious process within the hip.
794:
908:
198:. Factors that can help indicate septic arthritis rather than synovitis include a WBC count greater than 12×10/l, fever greater than 38.5 °C (101.3 °F),
347:
may result in a gradual onset of limping in children. It is often associated with night sweating, easy bruising, weight loss, and pain most prominent at night.
787:
109:. Limping may be caused by pain, weakness, neuromuscular imbalance, or a skeletal deformity. The most common underlying cause of a painful limp is
259:
of the head of the femur slips over the underlying bone. It most commonly presents with hip pain in males during puberty and is associated with
244:
may result in either a fracture, muscle bruising, or a contusion. It is the leading cause of a limp. Deliberate abuse is important to consider.
780:
368:
A limp at one hospital emergency department was the presenting complaint in 4% of children. It occurs twice as commonly in boys as in girls.
996:
327:
is a degenerative disease of the head of the femur which results in bone loss and deformity. It usually presents as a chronic condition.
324:
175:
252:
178:. Other important causes are infectious arthritis, osteomyelitis, and slipped capital femoral epiphysis in children.
118:
924:
607:
605:
602:
1020:
199:
991:
308:
1083:
957:
121:, may be present. The diagnostic approach involves ruling out potentially serious causes via the use of
336:
137:. A limp is the presenting problem in about 4% of children who visit hospital emergency departments.
947:
494:
Fischer SU, Beattie TF (November 1999). "The limping child: epidemiology, assessment and outcome".
17:
1015:
942:
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Sawyer JR, Kapoor M (February 2009). "The limping child: a systematic approach to diagnosis".
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31:
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Laine JC, Kaiser SP, Diab M (February 2010). "High-risk pediatric orthopedic pitfalls".
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38:
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547:
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465:
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Singer JI (March 1985). "The cause of gait disturbance in 425 pediatric patients".
191:
130:
114:
102:
853:
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167:
134:
110:
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have difficulty determining the location of leg pain, thus in this population,
675:
469:
1077:
832:
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A non-painful limp may be due to a number of mechanical conditions including
264:
224:
150:
1040:
885:
863:
683:
633:
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477:
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presents gradually with early morning stiffness, fatigue, and weight loss.
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216:
146:
106:
409:
803:
625:
89:
708:
1060:
848:
126:
85:
817:
772:
755:
81:
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Frick SL (April 2006). "Evaluation of the child who has hip pain".
113:; however, in the absence of trauma, other serious causes, such as
194:
can be difficult to separate from less serious conditions such as
260:
536:
220:
122:
914:
965:
215:
Other infections that classically lead to a limp include
37:"Lameness" redirects here. For lameness in horses, see
611:
170:. In those with no history of trauma, 40% are due to
698:
247:
145:A limp is a type of asymmetric abnormality of the
1075:
303:
455:
157:, with the body shifted over the affected hip.
493:
319:
788:
267:or death of the head of the femur may occur.
997:Systemic-onset juvenile idiopathic arthritis
581:
149:. When due to pain it is referred to as an
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27:Type of asymmetric abnormality of the gait
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255:(SCFE) is a condition in which the
186:
24:
25:
1095:
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253:Slipped capital femoral epiphysis
248:Slipped capital femoral epiphysis
219:(a bacterial infection spread by
119:slipped capital femoral epiphysis
552:10.2106/00004623-200408000-00005
402:10.1097/00006565-198503000-00003
363:
282:
530:
13:
1:
992:Juvenile idiopathic arthritis
371:
330:
309:Juvenile rheumatoid arthritis
304:Juvenile rheumatoid arthritis
230:
140:
133:. Initial treatment involves
279:and leg length differences.
227:(an infection of the bone).
181:
7:
1021:Adult-onset Still's disease
958:Connective tissue disorders
508:10.1302/0301-620X.81B6.9607
325:Legg–Calvé–Perthes syndrome
320:Legg–Calvé–Perthes syndrome
314:
202:greater than 40 mm/h,
176:Legg–Calvé–Perthes syndrome
10:
1100:
458:Emerg. Med. Clin. North Am
337:acute lymphocytic leukemia
270:
36:
29:
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676:10.1016/j.ocl.2005.12.003
470:10.1016/j.emc.2009.09.008
358:knee pain equals hip pain
240:Accidental or deliberate
235:
75:
70:
56:
51:
948:Enteropathic arthropathy
210:
1016:Palindromic rheumatism
943:Ankylosing spondylitis
886:Tuberculosis arthritis
664:Orthop. Clin. North Am
161:Differential diagnosis
103:asymmetric abnormality
32:Limp (disambiguation)
1004:Rheumatoid arthritis
626:10.2106/JBJS.E.00216
614:J Bone Joint Surg Am
540:J Bone Joint Surg Am
496:J Bone Joint Surg Br
30:For other uses, see
938:Psoriatic arthritis
464:(1): 85–102, viii.
351:Diagnostic approach
293:Transient synovitis
288:Transient synovitis
196:transient synovitis
172:transient synovitis
1084:Gait abnormalities
971:systemic sclerosis
933:Reactive arthritis
804:Diseases of joints
747:External resources
390:Pediatr Emerg Care
335:Cancers including
297:reactive arthritis
166:children is minor
155:Trendelenburg gait
1071:
1070:
1029:
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904:Chondrocalcinosis
770:
769:
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94:
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46:Medical condition
39:Lameness (equine)
16:(Redirected from
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1056:Bouchard's nodes
1009:Felty's syndrome
881:Septic arthritis
869:
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670:(2): 133–40, v.
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584:Am Fam Physician
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192:Septic arthritis
187:Septic arthritis
174:and 2% are from
131:joint aspiration
129:, and sometimes
115:septic arthritis
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21:
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1098:
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1051:Heberden's node
1034:Noninflammatory
1025:
980:
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854:Joint stiffness
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771:
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168:physical trauma
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135:pain management
111:physical trauma
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5:
1097:
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1046:Osteoarthritis
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828:Oligoarthritis
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546:(8): 1629–35.
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502:(6): 1029–34.
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833:Polyarthritis
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823:Monoarthritis
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277:hip dysplasia
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265:osteonecrosis
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225:osteomyelitis
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151:antalgic gait
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101:is a type of
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19:
1041:Hemarthrosis
925:Seronegative
911:(Pseudogout)
864:Inflammatory
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364:Epidemiology
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341:osteosarcoma
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283:Inflammatory
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257:growth plate
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217:Lyme disease
214:
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164:
144:
98:
96:
43:
396:(1): 7–10.
127:blood tests
90:orthopedics
1061:Osteophyte
873:Infectious
849:Joint pain
732:DiseasesDB
372:References
331:Neoplastic
231:Mechanical
221:deer ticks
141:Definition
86:pediatrics
976:Sjögren's
818:Arthritis
756:eMedicine
182:Infection
82:Neurology
77:Specialty
1078:Category
842:Symptoms
684:16638444
634:16757758
596:19202969
560:15292409
516:10615981
478:19945600
315:Vascular
18:Lameness
896:Crystal
811:General
524:2141675
418:1198461
410:3843430
261:obesity
105:of the
71:Limping
682:
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558:
522:
514:
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408:
343:, and
236:Trauma
223:) and
123:X-rays
985:Other
737:22069
726:719.7
520:S2CID
414:S2CID
295:is a
271:Other
211:Other
915:Gout
909:CPPD
721:9-CM
680:PMID
630:PMID
592:PMID
556:PMID
544:86-A
512:PMID
474:PMID
406:PMID
147:gait
107:gait
99:limp
52:Limp
966:SLE
717:ICD
672:doi
622:doi
548:doi
504:doi
466:doi
398:doi
204:CRP
200:ESR
117:or
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