Feature Article

The limping child: an approach to diagnosis and management

Angela Cox, Roger Allen



Investigating a child with a limp requires careful consideration because the differential diagnoses are broad. The condition is rarely an emergency but it can be serious and debilitating.

Key Points

  • History, examination and simple laboratory tests can identify most serious causes of limp in children.
  • The presence of acute pain, raised inflammatory markers, fever and nonweightbearing makes septic arthritis the most likely diagnosis.
  • It is important to remember that muscle weakness and malignancy can be causes of limp.
  • Referred pain may be present and the pathology may not be at the site of the pain.