Pediatric Limp Differential Diagnoses

Updated: Sep 26, 2016
  • Author: Brian Wai Lin, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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DDx

Diagnostic Considerations

Table. Diagnostic Considerations for Limping, Organized by System and Patient Age (Open Table in a new window)

System/Age

Toddler (1-3 y)

Child (4-10 y)

Adolescent (11-16 y)

 

Infectious/Inflammatory

Septic arthritis

Septic arthritis

Septic arthritis (consider Neisseria gonorrhoeae)

 

Osteomyelitis

Osteomyelitis

 

 

Transient synovitis

Transient synovitis

 

 

Meningitis

Diskitis

 

 

Orthopedic/Mechanical

Fractures (consider toddler's, nonaccidental trauma)

Fractures

Fractures (consider stress fractures, overuse syndromes)

 

Osteochondroses

Osteochondroses (consider Legg-Calve-Perthes)

Osteochondroses (consider Osgood-Schlatter)

 

Strains/sprains

Strains/sprains

Strains/sprains

 

Foot/shoe foreign bodies

Foot/shoe foreign bodies

 

 

Leg length discrepancy

 

Slipped capital femoral epiphysis

 

Developmental dysplasia of the hip

 

Chondromalacia patellae

 

 

 

Osteochondritis dissecans

 

Neoplastic

Neuroblastoma

Osteosarcoma

Osteosarcoma

 

 

Leukemia (ALL)

Ewing's sarcoma

Ewing's sarcoma

 

 

Osteochondroma

Osteochondroma

Osteochondroma

 

 

 

Osteoid osteoma

Osteoid osteoma

 

Neuromuscular

Hereditary motor sensory neuropathies (includes Charcot-Marie-Tooth)

 

Myositis

 

Peripheral neuropathy

 

Muscular dystrophy

 

Reflex sympathetic dystrophy

 

Rheumatologic

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis

 

 

Henoch-Schonlein purpura

Henoch-Schonlein purpura

 

 

Gout/pseudogout

Gout/pseudogout

Gout/pseudogout

 

 

SLE

SLE

 

Serum sickness & serum sickness-like reactions

Rheumatic fever

Rheumatic fever

 

Hematologic

Sickle cell disease (vaso-occlusive crisis)

 

Hemophilia (hemarthrosis)

 

Intra-abdominal

Appendicitis

Appendicitis

Appendicitis

 

Psoas abscess

Psoas abscess

Psoas abscess

 

 

 

Testicular torsion

 

 

 

PID

 

Differential Diagnoses