48:
344:
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
154:
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
49:
288:
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.
50:
52:
195:
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.
252:. 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,
142:, 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
526:
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".
705:
601:
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".
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349:. 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.
783:
897:
187:. 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),
336:
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.
776:
98:. Limping may be caused by pain, weakness, neuromuscular imbalance, or a skeletal deformity. The most common underlying cause of a painful limp is
248:
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
233:
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.
769:
357:
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.
985:
316:
is a degenerative disease of the head of the femur which results in bone loss and deformity. It usually presents as a chronic condition.
313:
164:
241:
167:. Other important causes are infectious arthritis, osteomyelitis, and slipped capital femoral epiphysis in children.
107:
913:
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110:, may be present. The diagnostic approach involves ruling out potentially serious causes via the use of
325:
126:. A limp is the presenting problem in about 4% of children who visit hospital emergency departments.
936:
483:
Fischer SU, Beattie TF (November 1999). "The limping child: epidemiology, assessment and outcome".
1004:
931:
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Sawyer JR, Kapoor M (February 2009). "The limping child: a systematic approach to diagnosis".
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Laine JC, Kaiser SP, Diab M (February 2010). "High-risk pediatric orthopedic pitfalls".
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Singer JI (March 1985). "The cause of gait disturbance in 425 pediatric patients".
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have difficulty determining the location of leg pain, thus in this population,
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A non-painful limp may be due to a number of mechanical conditions including
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presents gradually with early morning stiffness, fatigue, and weight loss.
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135:
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115:
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Frick SL (April 2006). "Evaluation of the child who has hip pain".
102:; however, in the absence of trauma, other serious causes, such as
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can be difficult to separate from less serious conditions such as
249:
525:
209:
111:
903:
954:
204:
Other infections that classically lead to a limp include
26:"Lameness" redirects here. For lameness in horses, see
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159:. In those with no history of trauma, 40% are due to
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236:
134:A limp is a type of asymmetric abnormality of the
1064:
292:
444:
146:, with the body shifted over the affected hip.
482:
308:
777:
256:or death of the head of the femur may occur.
986:Systemic-onset juvenile idiopathic arthritis
570:
138:. When due to pain it is referred to as an
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16:Type of asymmetric abnormality of the gait
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244:(SCFE) is a condition in which the
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13:
14:
1084:
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242:Slipped capital femoral epiphysis
237:Slipped capital femoral epiphysis
208:(a bacterial infection spread by
108:slipped capital femoral epiphysis
541:10.2106/00004623-200408000-00005
391:10.1097/00006565-198503000-00003
352:
271:
519:
1:
981:Juvenile idiopathic arthritis
360:
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298:Juvenile rheumatoid arthritis
293:Juvenile rheumatoid arthritis
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129:
122:. Initial treatment involves
268:and leg length differences.
216:(an infection of the bone).
170:
7:
1010:Adult-onset Still's disease
947:Connective tissue disorders
497:10.1302/0301-620X.81B6.9607
314:Legg–Calvé–Perthes syndrome
309:Legg–Calvé–Perthes syndrome
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191:greater than 40 mm/h,
165:Legg–Calvé–Perthes syndrome
10:
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447:Emerg. Med. Clin. North Am
326:acute lymphocytic leukemia
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459:10.1016/j.emc.2009.09.008
347:knee pain equals hip pain
229:Accidental or deliberate
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45:
40:
937:Enteropathic arthropathy
199:
1005:Palindromic rheumatism
932:Ankylosing spondylitis
875:Tuberculosis arthritis
653:Orthop. Clin. North Am
150:Differential diagnosis
92:asymmetric abnormality
21:Limp (disambiguation)
993:Rheumatoid arthritis
615:10.2106/JBJS.E.00216
603:J Bone Joint Surg Am
529:J Bone Joint Surg Am
485:J Bone Joint Surg Br
19:For other uses, see
927:Psoriatic arthritis
453:(1): 85–102, viii.
340:Diagnostic approach
282:Transient synovitis
277:Transient synovitis
185:transient synovitis
161:transient synovitis
1073:Gait abnormalities
960:systemic sclerosis
922:Reactive arthritis
793:Diseases of joints
736:External resources
379:Pediatr Emerg Care
324:Cancers including
286:reactive arthritis
155:children is minor
144:Trendelenburg gait
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893:Chondrocalcinosis
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35:Medical condition
28:Lameness (equine)
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1045:Bouchard's nodes
998:Felty's syndrome
870:Septic arthritis
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659:(2): 133–40, v.
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181:Septic arthritis
176:Septic arthritis
163:and 2% are from
120:joint aspiration
118:, and sometimes
104:septic arthritis
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1023:Noninflammatory
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124:pain management
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1035:Osteoarthritis
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1030:Hemarthrosis
914:Seronegative
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853:Inflammatory
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353:Epidemiology
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330:osteosarcoma
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272:Inflammatory
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246:growth plate
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206:Lyme disease
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133:
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32:
385:(1): 7–10.
116:blood tests
79:orthopedics
1050:Osteophyte
862:Infectious
838:Joint pain
721:DiseasesDB
361:References
320:Neoplastic
220:Mechanical
210:deer ticks
130:Definition
75:pediatrics
965:Sjögren's
807:Arthritis
745:eMedicine
171:Infection
71:Neurology
66:Specialty
1067:Category
831:Symptoms
673:16638444
623:16757758
585:19202969
549:15292409
505:10615981
467:19945600
304:Vascular
885:Crystal
800:General
513:2141675
407:1198461
399:3843430
250:obesity
94:of the
60:Limping
671:
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332:, and
225:Trauma
212:) and
112:X-rays
974:Other
726:22069
715:719.7
509:S2CID
403:S2CID
284:is a
260:Other
200:Other
904:Gout
898:CPPD
710:9-CM
669:PMID
619:PMID
581:PMID
545:PMID
533:86-A
501:PMID
463:PMID
395:PMID
136:gait
96:gait
88:limp
41:Limp
955:SLE
706:ICD
661:doi
611:doi
537:doi
493:doi
455:doi
387:doi
193:CRP
189:ESR
106:or
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