Pediatric Rheumatology Series, Lecture:4 – Approach to a child with limp by Dr. Sushma Shree

Develop a systematic approach to assess a limping child by integrating age, onset, duration, and associated symptoms to narrow the differential diagnosis.

Differentiate between urgent and non-urgent causes (e.g., septic arthritis vs. transient synovitis) using red flag signs like fever, inability to bear weight, or severe pain.

Recognize age-specific common causes, such as developmental dysplasia of the hip in infants, transient synovitis or Legg-Calvé-Perthes disease in early childhood, and slipped capital femoral epiphysis in adolescents.

Understand the role of physical examination, including gait observation, joint range of motion, and localized tenderness, in identifying the affected site and likely pathology.

Interpret basic investigations appropriately, including CBC, ESR/CRP, X-rays, and ultrasound, and understand when to escalate to MRI or specialist referral.

Appreciate the importance of early diagnosis and intervention, especially in infections or orthopedic emergencies, to prevent long-term disability.

Reinforce communication with caregivers, ensuring clear explanation of diagnosis, need for follow-up, and possible red flag signs requiring urgent re-evaluation.