Learning objectives
- Role of imaging (plain films,
ultrasound,
CT ,MRI and bone scintigraphy) in patients presenting with limping
- Radiological findings of different diseases diagnosed by different radiological tools in a child presenting with limping
Background
Limp is defined as an uneven,
jerky,
or laborious gait,
usually caused by pain,
weakness,
or deformity.
Limping in a child can arise from the hip /lower limbs pathology or from remote sites including the spine,
abdomen,
or pelvis).
Limping in children is fairly common.
The list of potential etiologies is long,
varied and ranges from benign to life-threatening.
Once a gait abnormality has been identified,
a thorough history and physical examination if needed should be undertaken to narrow the differential diagnosis.
Patients often have...
Findings and procedure details
Role of imaging:
Standard radiography is the initial imaging study of choice in the limping child.
Orthogonal images of the hip should consist of AP and frog-leg lateral views of the hips.
In very young children or those whose physical examination does not reveal a focal source of pain,
radiographs of the entire lower extremity should be obtained.
As many as 20% of children have unsuspected fractures.
Radiographs can be helpful in the diagnosis of fracture,
osteomyelitis,
Legg-Calvé-Perthes disease,
slippedcapital femoral epiphysis,
bone tumors (both...
Conclusion
Besides detailed history and physical examination,
radiology plays an important role in management of children presenting with limping.
Personal information
Dr Nehal Mohamed Saloum.
Clinical Fellow,
Diagnostic Imaging.
Hamad Medical Corporation,
Doha,
Qatar.
Email:
[email protected].
References
1.Mark C Clark.
Approach to the child with a limp – UpToDate.
2.Brian Coley et al,
Caffey's Pediatric Diagnostic Imaging Twelfth Edition 2013; 136,137- 142.
3.Bardy M.
The child with a limb.
J Ppediatr Health.
1993; 77:226.
4.S.
Pauroso et al.
Transient synovitis of the hip: Ultrasound appearance.
Mini-pictorial essay.
Journal of Ultrasound.
2011; 14.
5.Mark C Clark.
Overview of the causes of limp in children Overview of the causes of limp in children– UpToDate.
6.Jeremy K Rush et al.
Limping Child.
2017.
7.N.
Jain...