Monday, 4 July 2016

Limp in Children : diagnostic strategy

Probability diagnosis

  • post trauma/intense exercise causing strain syndromes
  • ill fitting shoes
  • Hip disorders, esp. transient synovitis
  • Heel disorders (12-14 years)
Serious disorders not to be missed
  • A. Toddlers
    • DDH
    • Child abuse
    • Septic arthritis
    • Foreign body (e.g. needle in foot)
  • 4-8 years
    • Perth's disorder
    • Transient synovitis
  • Adolescents
    • SCFE
    • Avulsion injuries (e.g. ischial tuberosity)
    • Osteochondritis dissecans of knee
    • Duchenne muscular dystrophy
  • All groups
    • Septic infections
      • septic arthritis
      • osteomyelitis
      • tuberculosis
    • Tumour
    • Juvenile chronic arthritis
    • Spinal disorders
      • discitis
      • fracture
  • Pitfalls
    • Foreign body 
    • Osteochonndritis (aseptic necrosis)
      • femoral head - Perthes' disorder
      • knee - osgood-schlatter disorder
      • calcaneum - sever disorder
      • navicular - kohler disorder
    • Myalgia 
      • growing pains
    • Overuse syndrome 
      • patellar tendonopathy 
    • Stress fracture
    • Paget's disease 

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