Limp is defined as an asymmetric gait, and is a deviation from the normal gait pattern expected for a child's age. Causes can vary from benign to potentially life-threatening (e.g., infection, tumors, nonaccidental injury). Appropriate evaluation requires an understanding and knowledge of normal and abnormal gait patterns, potential causes, and "red flags".[1] [2] The assessment of limp will depend on whether the presentation is acute or chronic.[3]
Trauma, causing transient injury, is the most common cause of limp, although the potential for serious or life-threatening causes requires a thorough clinical assessment and appropriate investigations.[2] Challenges in making a diagnosis include the complexity of history taking in the pediatric setting. Often, the history is taken from the caregiver, and the trauma may have occurred in a childcare setting, rather than at home. The history may therefore be vague and inaccurate.
Careful examination of all joints is necessary, as is general assessment including abdominal, neurologic, and developmental assessments.[4]
