Acutely Limping child

DDx

 

CDH / LLD

 

Transient Synovitis/ Septic Arthritis

 

Perthes 

 

SUFE

 

Inflammatory Arthritis

 

Timeline

 

0-2 DDH

2-5 septic arthritis

2-10 synovitis

5-10 perthes

10-15 SUFE

 

5 questions

 

Is limp due to pain?

What type of limp?

Is limp gradual / sudden?

Any localizing features?

Is the child unwell?

 

Examination

 

Gait

Standing

Supine on couch

 

Investigations

 

X-ray

Bone Scan

US / MRI

 

Haematological tests

 

FBE / ELFT's

ESR / CRP

RF / ANA