Title:Non-traumatic Limping in the Child: A Pediatric Rheumatologist Perspective
on Etiology, Clinical Evaluation, Laboratory Diagnosis, and Diagnostic
Algorithms using Musculoskeletal Ultrasound (MSUS)
Volume: 20
Issue: 3
Author(s): Miroslav Harjacek*
Affiliation:
- Department of Pediatrics, United Arab Emirates University, CMHS, Al Ain, UAE
Keywords:
Child, limp, pediatric rheumatologists, gait, juvenile idiopathic arthritis, dermatomyositis, neoplasms, ultrasound.
Abstract: Limping refers to an asymmetrical gait that deviates from the typical gait pattern expected
for a child of a certain age. In most children, limping is caused by a mild, self-limiting event,
such as a contusion, strain, or sprain. However, a child's limping is always a pathological finding
that poses a particular diagnostic challenge and necessitates a thorough assessment. The pediatrician
must weigh a wide range of acute and chronic potential causes of a non-traumatic limp, including
infection, neoplasia, and chronic inflammatory disorders. A thorough history and clinical examination
will help us arrive at the correct diagnosis. Understanding the typical gait is essential to recognizing
and correctly interpreting the disordered one. The examination of child limping involves using
a variety of diagnostic methods. Efficient and cost-effective diagnosis and treatment of the underlying
condition requires a systematic approach. This review provides the pediatric rheumatologist
perspective and approach for evaluating non-traumatic limp in children, with a focus on the use
of point-of-care (PoC) musculoskeletal ultrasound (MSUS) as a crucial tool in daily practice.