The limping child: a clinical approach to diagnosis

Abbassian, Ali

doi:10.12968/hmed.2007.68.5.23330

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…It is considered a challenge to the orthopedic surgeons [20, 21], and surgeons should know the different pathologies that cause limping [19]. In all limping children, calcaneal fractures should be suspected even without trauma history [5].…”

Section: Discussionmentioning

confidence: 99%

An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment

Guterres

Ribeiro

2015

J Clin Med Res

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Calcaneal fractures are considered uncommon accounting for 0.005-0.41% of all children fractures. Few reports concerning treatment are available. Most of these fractures are non-displaced/minimally displaced and are associated with a fall of less than 1 m. The aim of this case report was to discuss the diagnosis and treatment of a child calcaneal fracture, an atypical presentation despite the high energy mechanism of trauma. A 7-year-old child fell from a 5-m ladder with all his weight on his right heel. Significantly hind-foot reduced range of motion associated with a lateral/plantar calcaneal swelling and pain was found. Neurovascular examination and other parts of the body were normal. Radiograph showed an undisplaced calcaneal body fracture and computed tomography confirmed no subtalar joint involvement. A splint followed by plaster was applied. Weight bearing and deambulation were not allowed. After 4 weeks, no pain and limping was reported by the child’s parents. Plaster was removed and radiograph showed fracture consolidation. Patient had no complaints of pain, no restrictions in range of motion and normal walking. Limping in children is a difficult complaint to assess. Differential diagnoses of a calcaneal fractures should be performed, even without a history of trauma or a history of trivial trauma.

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Section: Discussionmentioning

confidence: 99%

An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment

Guterres

Ribeiro

2015

J Clin Med Res

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“…Esses pacientes são os que acarretam maior dificuldade diagnóstica no que diz respeito aos problemas da marcha (2,8,9) . Trata-se de um grupo que, pela pouca idade, é pouco colaborador, tanto em relação às informações colhidas na anamnese, que na maioria das vezes é obtida somente através das queixas dos pais, quanto na realização do exame físico.…”

Section: Período Infantil -De Um Aos Três Anos De Idadeunclassified

“…O diagnóstico das condições que acarretam claudicação na criança é um desafio (1,2) , mesmo para profissionais mais experientes e que estejam acostumados a lidar com pacientes que não conseguem dar maiores informações. Normalmente, os distúrbios que causam alteração da marcha podem ser divididos de acordo com o padrão da claudicação e a idade em que aparecem (3) .…”

Section: Introductionunclassified

Claudicação na criança

Santili¹,

Júnior²,

Goiano³

et al. 2009

Rev. bras. ortop.

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RESUMOA claudicação na criança é uma queixa frequente nos consultó-rios dos pediatras, dos ortopedistas pediátricos e nos pronto-socorros. Diversas são as causas para essa condição e identificá-las torna-se um desafio. Quanto maior a idade do paciente, melhor é a coleta da anamnese e mais completo se torna o exame físico, facilitando o raciocínio médico na busca da origem do distúrbio. Para facilitar a abordagem, três grupos etários podem e devem ser considerados. No grupo etário infantil, de um aos três anos de idade, os diagnósticos mais prováveis incluem: sinovite transitória, artrite séptica, desordens neurológicas (paralisia cerebral (PC) branda e distrofia muscular), displasia do desenvolvimento do quadril (DDQ), coxa vara, artrite reumatoide juvenil (ARJ) e neoplasias (osteoma osteoide, leucemia); no grupo etário escolar, dos quatro aos 10 anos de idade, além dos diagnósticos acima, doença de Legg-Calvé-Perthes, menisco discoide, discrepâncias de comprimento dos membros inferiores e "dor do crescimento"; nos adolescentes, dos 11 aos 15 anos de idade: epifisiólise, DDQ, condrólise, síndromes de overuse, osteocondrite dissecante e coalizão tarsal. A proposta deste trabalho é atualizar o leitor em relação à abordagem do paciente pediátrico que apresenta claudicação e discutir as suas prováveis causas. Descritores

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“…These patients are those that result in greatest diagnostic difficulty with regard to gait problems 2 , 8 , 9 . Because of being of such a young age, this is a group that is not very helpful in relation to the data gathered during the interview, which is most often obtained only through the complaints of the parents, as well as the physical examination.…”

Section: The Toddler Period-from One To Three Years Of Agementioning

confidence: 99%

“…The diagnosis of conditions that cause claudication in children is a challenge 1 , 2 , even for more experienced professionals that are accustomed to dealing with patients who are not forthcoming with information. Usually, disorders that cause abnormal gait can be divided according to the pattern of claudication and the age at which they appear (3) .…”

Section: Introductionmentioning

confidence: 99%

Limping in Children

Santili

Júnior

Goiano

et al. 2009

Revista Brasileira de Ortopedia (English Edition)

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Limping in children is a common complaint at pediatric, pediatric orthopaedic offices and in emergency rooms. There are several causes for this condition, and identifying them is a challenge. The older the patient, the better the anamnesis and more detailed the physical examination will be, enabling an easier medical assessment for searching the source of the disorder. In order to make the approach easier, three age groups can and should be considered. Among infants (1 to 3 years old), diagnosis will most likely be: transitory synovitis, septic arthritis, neurological disorders (mild brain palsy (BP) and muscular dystrophy), congenital hip dislocation (CHD), varus thigh, juvenile rheumatoid arthritis (JRA) and neoplasias (osteoid osteoma, leukemia); in the scholar age group, between 4 and 10 years old, in addition to the diagnoses above, Legg-Calvé-Perthes disease, discoid meniscus, inferior limbs discrepancy and unspecific muscular pain; in adolescents (11 to 15 years old): slipped capital femoral epiphysis, congenital hip dislocation, chondrolysis, overuse syndromes, dissecans osteochondritis, and tarsal coalition. The purpose of this study is to provide an update on how to approach pediatric patients presenting with limping, and to discuss its potential causes.

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The limping child: a clinical approach to diagnosis

Cited by 9 publications

References 5 publications

An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment

An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment

Claudicação na criança

Limping in Children

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