Acute Childhood Limp

🔍 When to Suspect

A child presenting with a limp, inability to bear weight, recent trauma, or systemic signs such as fever

From the full topic in The Ocean Library: Acute Childhood Limp

🧭 When to suspect

A limp is a presentation, not a diagnosis. In a child, it requires careful clinical evaluation to differentiate benign, self-limiting conditions from limb- or life-threatening pathology.

The primary role of the GP is to identify red flags that suggest serious underlying causes such as septic arthritis, osteomyelitis, malignancy, or non-accidental injury (NAI), and to recognise age-specific orthopaedic conditions that require urgent intervention to prevent long-term joint destruction.

The differential diagnosis is heavily guided by the child's age:

Age Group	Classic Differentials
0–3 years	Septic arthritis, osteomyelitis, developmental dysplasia of the hip (DDH), non-accidental injury (NAI).
3–10 years	Transient synovitis (most common), Perthes' disease, septic arthritis, leukaemia.
10–16 years	Slipped capital femoral epiphysis (SCFE/SUFE), avulsion fractures, Osgood-Schlatter disease, juvenile idiopathic arthritis (JIA).

Source: BMJ · RCEM

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