Limp (peds): Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Pediatric hip DDX}} | |||
===Other causes of limping=== | |||
*Developmental dysplasia | *Developmental dysplasia | ||
*Fracture | *Fracture | ||
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**Metastatic neuroblastoma | **Metastatic neuroblastoma | ||
*Osteomyelitis | *Osteomyelitis | ||
*Myositis | *Myositis | ||
*Other: | *Other: | ||
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**Meningitis | **Meningitis | ||
**Epidural [[abscess]] (spine) | **Epidural [[abscess]] (spine) | ||
==Evaluation== | ==Evaluation== | ||
Revision as of 04:07, 17 May 2017
Background
- It can be difficult to differentiate hip from knee pain in children
Clinical Features
Differential Diagnosis
Pediatric limp
Hip Related
- Acute rheumatic fever
- Developmental dysplasia of hip
- Femur fracture
- Juvenile idiopathic arthritis
- Legg-Calve-Perthes disease
- Septic arthritis of the hip (peds)
- Lyme disease arthritis
- Slipped capital femoral epiphysis
- Transient (toxic) synovitis
- Osteosarcoma
Other Causes of Limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
Other causes of limping
- Developmental dysplasia
- Fracture
- Toddler's fracture
- Tillaux fracture, adolescent
- Neoplasm:
- Leukemia
- Ewings
- Osteogenic sarcoma
- Metastatic neuroblastoma
- Osteomyelitis
- Myositis
- Other:
- Appendicitis
- Meningitis
- Epidural abscess (spine)
Evaluation
- X-ray hip, knee
- Consider CBC, ESR, total CK
- Consider hip ultrasound (vs CT)
Kocher Criteria for septic arthritis of the hip
- ESR > 40 mm/hr
- WBC > 12,000/microliter
- Refusal or inability to weight bear on affected joint
- Fever 38.5° C or greater
| Number of Kocher Criteria | Chance of Septic Joint |
| 1 | 3% |
| 2 | 40% |
| 3 | 93% |
| 4 | 99% |