The limping child

Limping in children is never normal and it deserves a full evaluation. The causes of limping are extensive and very often age-specific. In considering the differential diagnosis the clinician faces a rather broad category of possible etiologies and concomitant diseases, such as traumatic, infectious, neoplastic, inflammatory, congenital, neuromuscular or developmental. It is necessary to understand the normal gait cycle in order to recognize and correctly interpret the pathological one. A systematic approach should include a thorough history and physical examination combined with appropriate imaging studies and laboratory testing. There are several diagnostic modalities that are available in the evaluation of a child with a limp. A thorough understanding of the advantages, disadvantages and limitations of these modalities will help in identifying those children who require urgent diagnostic and therapeutic interventions in the emergency department.

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