(May 2019) Limping is a common complaint that prompts parents to seek medical attention for their child. Usually the limp is caused by minor injury that will get better by itself. However, limping that last longer than a week and that is not improving may indicate a more serious condition requiring medical evaluation. The challenge for both the parent and the physician involve the difficulty in young children at describing their symptoms as well as with older children trying to play through their pain even when it is not safe. As a parent, it’s important to understand a limping child.
What is Causing My Child to Limp?
Injury:
Minor injuries such as contusions, low-grade sprains and strains will resolve quickly. Pain and limping related to more serious ligament sprains and muscle strains as well as traumatic and stress fractures will however persist.
Overuse injuries:
Overuse injuries to various sites of growth can also occur – typically the heel, mid foot, leg, kneecap, as well as the pelvis. These causes of pain fall under the general diagnosis of apophysitis. Patella maltracking as well as patella tendinitis or jumpers knee may also be a concern.
Infection and inflammatory disease:
Viral and bacterial infections can settle in growing bones and adjacent joints causing significant pain at times. Several types of inflammatory disease such as juvenile arthritis can also be a cause.
More Serious Issues Behind a Limp
Other less common causes of leg pain or limping can be related to congenital abnormalities such as a congenital hip dislocation or congenital foot deformities
Legg-Perthes disease is caused by insufficient blood supply to the hip, leading to a flattening of the ball within the ball and socket joint of the hip. This condition usually occurs between the ages of 4 and 10 in otherwise healthy children.
Slipped capital femoral epiphysis occurs just before puberty and is a slippage of the growth plate within the hip socket.
Diskitis is an inflammation of the disc spaces within the spine which can also cause painful limping.
Nervous system disorders create a problem with the nerve signals that control walking. Disorders of the nervous system can cause weakness or tightness in the muscles which can also cause a child to walk differently.
Tumors of various types can grow into bone and soft tissue and cause pain locally.
A thorough history and physical exam by your physician accompanied by appropriate imaging which may include studies such as x-rays, ultrasound, bone scans, MRI, or CT scan can readily provide a diagnosis. Occasionally bloodwork will also be needed to make the appropriate diagnosis and develop a treatment plan.
If your child has an issue lasting more than a few days, we’re here to help.
https://orthoinfo.aaos.org/en/diseases–conditions/the-limping-child/
Dr. Terral received his MD from Louisiana State University Medical Center in New Orleans, followed by residency in the Department of Orthopaedic Surgery at the University of Mississippi Medical Center in Jackson, MS. He is Board Certified and Fellowship Trained in joint reconstruction.
