Title:The Limping Child: A Guide for the Trainees
Volume: 20
Issue: 4
Author(s): Norah AlRohaimi, Hamad Alkhalaf and Jubran Alqanatish*
Affiliation:
- Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 14611, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, 11481, Saudi Arabia
- King Abdullah Specialist Children’s Hospital, King Abdulaziz Medical City (National Guard Health Affairs), Riyadh, 11426, Saudi Arabia
Keywords:
Child, approach, limping, gait, pain, weakness, deformity.
Abstract: Limping is a common presenting complaint in children. Despite this, it remains to be a
diagnostic challenge for treating physicians due to an expanded list of etiologies. It arises from a
spectrum of disorders, ranging from physiological variations of gait at different stages of development
to systemic causes, such as inflammatory diseases or musculoskeletal infections. On rare occasions,
non-musculoskeletal causes could result in limping. The diagnostic challenge increases in
younger age children where a detailed physical examination that helps identify the exact source of
pathology may not be possible. In older patients who have a well-developed gait cycle, the physical
assessment might be easier. Clinical assessment in a child presenting with a limp includes gait analysis,
which is essential to guide the appropriate request of diagnostic laboratory tests and imaging
studies. In this paper, we provide a practical guide for a trainee in General Pediatric and Pediatric
Rheumatology on an approach to a limping child, aiming to identify the common causes of limping
and to describe normal and abnormal gait cycles. We also discuss other diagnostic considerations in
the assessment of these children.
