{"id":1758,"date":"2017-09-04T06:41:57","date_gmt":"2017-09-04T06:41:51","guid":{"rendered":"http:\/\/papergp.com\/index.php\/paediatrics\/limping-child\/"},"modified":"2023-01-24T11:25:25","modified_gmt":"2023-01-24T11:25:25","slug":"limping-child","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/paediatrics\/limping-child\/","title":{"rendered":"Limping child"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4>Differential diagnosis<\/h4>\n<ul>\n<li>Septic arthritis &#8211; fever, red, swollen, warm joint<\/li>\n<li>DDH<\/li>\n<li>Toddle fracture &#8211; sudden twist or unwitnessed fall, tender over tibial shaft<\/li>\n<li>Non-accidental injury<\/li>\n<li>Transient synovitis &#8211; usually 4-8yo, may follow viral infection<\/li>\n<li>Perthes&#8217; disease &#8211; usually 4-8yo, similar to synovitis but symptoms do not settle<\/li>\n<li>SUFE &#8211; usually &gt;10yo, obese, boys, can be bilateral<\/li>\n<li>Referred pain<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Data gathering<\/h4>\n<ul>\n<li>Red flags &#8211; fever, systemically unwell<\/li>\n<li>Others &#8211; trauma, DDH risk factors, other joint problems<\/li>\n<li>Examine &#8211; temp, pGALS &#8211; Gait (+tiptoes and heels), Legs (hip, knee), Spine<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4>Clinical management<\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>X-ray\n<ul>\n<li>consider even for trivial trauma as children are more prone to subluxation or fracture<\/li>\n<\/ul>\n<\/li>\n<li>USS \/ Bloods\n<ul>\n<li>refer if considering<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Treatment\n<ul>\n<li>Suspected transient synovitis\n<ul>\n<li>If 3-9 years old, well, afebrile, mobile and limping less than 48hr\n<ul>\n<li>Reassess after 48hr &#8211; if symptoms resolving, likely transient synovitis<\/li>\n<li>If symptoms fail to resolve after 7 days, consider referral<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Other causes\n<ul>\n<li>Require secondary care input<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Followup \/ Safety-net\n<ul>\n<li>Refer\n<ul>\n<li>Child &lt; 3 years old &#8211; transient synovitis is rare and septic arthritis\/NAI more common<\/li>\n<li>Child &gt; 9 years old with pain or restricted hip movement &#8211; to rule out SUFE<\/li>\n<li>Fever<\/li>\n<li>Systemically unwell<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Septic arthritis &#8211; fever, red, swollen, warm joint DDH Toddle fracture &#8211; sudden twist or unwitnessed fall, tender over tibial shaft Non-accidental injury Transient synovitis &#8211; usually 4-8yo, may follow viral infection Perthes&#8217; disease &#8211; usually 4-8yo, similar to synovitis but symptoms do not settle SUFE &#8211; usually &gt;10yo, obese, boys, can be &hellip; <a href=\"https:\/\/papergp.com\/index.php\/paediatrics\/limping-child\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Limping child<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":96,"menu_order":86,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1758","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1758","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=1758"}],"version-history":[{"count":4,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1758\/revisions"}],"predecessor-version":[{"id":1942,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/1758\/revisions\/1942"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/96"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=1758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}