Limp in Child
General or Other | Paediatrics | Limp in Child (Symptom)
Lameness in the child is one of the most frequent symptoms in emergency departments of hospitals. Under their apparent simplicity hides a number of different diseases. The main clinical signs of lameness is pain. The child may have more marked functional impairment. The lower limb is in abduction-external rotation and flexion antalgic position.
If a child is limping, the limp is usually due to a minor injury such as a sprain or splinter. But if there is no obvious cause, it may indicate a serious underlying medical condition. The most common medical causes of an unexplained limp in a child are: irritable hip, a severe viral infection, juvenile arthritis, the thigh bone slipping from the hip socket (slipped upper femoral epiphysis).
Diagnosis and Treatment
To detect the cause, the child should be questioned by the characteristics of pain, time of onset, duration, repetition and intensity. It should be sought involvement of other joints or a history of ankylosing spondylitis or chronic polyarthritis. There must be a bilateral examination comparing both hips, initially with the child standing and then lying. They seek the range of motion: flexion, separation, adduction, extension and rotation.
To better examine the movements of internal rotation is practical to place the patient in the prone position. It should be noted the existence of muscle atrophy. The complete clinical examination looks for: general alterations (fever, lymph node and spleen), exploration of other joints.