To review the diagnostic workup and appropriate imaging recommendations for a child presenting with a limp.
To discuss the pathology and to illustrate the imaging findings of etiologies of non-traumatic limp or hip pain in the pediatric age.
A limp represents a deviation from a normal age-appropriate gait pattern,
typically manifesting as jerky or laborious ambulation.
It is a common pediatric presentation and is often attributed to primary hip pathology,
but the spine,
or knee can also be implicated.
These multiple possible etiologies,
together with the barriers in communication common in the pediatric age,
pose a diagnostic challenge to the clinician.
physical examination and laboratory tests may narrow the differential diagnosis.
Nevertheless imaging is often essential in the determination...
Imaging findings OR Procedure Details
The patient age,
localization of pain when possible,
length of time of symptoms,
previous history of trauma or infection,
signs of systemic illness such as fever and tachycardia,
and laboratory findings all help direct the focus of imaging.
Certain diseases are more common in certain age groups.
Transient synovitis of the hip and undiagnosed developmental dysplasia of the hip (DDH) should be considered in infants and toddlers presenting with refusal to weight bear or reluctance to use the limb.
Between 4 and 10 years of...
Limp in children is not uncommon and results from many different diseases arising from the hip joint itself or referred from other territories.
Clinical history and physical examination are usually complemented by imaging.
With the exception of infants being evaluated for developmental hip dysplasia,
pediatric patients with suspected hip pathology are generally first imaged with AP and frog-leg lateral views of the pelvis to rule out any bony injury.
Ultrasound helps to differentiate which hips require early intervention and guides needle aspiration of joint fluid...
The acutely limping preschool and school-age child: an imaging perspective.
Semin Musculoskelet Radiol 2018; 22:46-56
Sonography for the investigation of a child with a limp.
AJUM 2010; 13(3):23-30
Sah M,Chakraverty J,Evans A,Kamath S.
Radiological approach to a child with hip pain.
Clinical Radiology 2013; 68:1167-1178
Pediatric hip: pearls and pitfalls.
Semin Musculoskelet Radiol 2013; 17:328-338
Imaging of non-traumatic acute hip pain...