Non-traumatic Limping in the Child: A Pediatric Rheumatologist Perspective on Etiology, Clinical Evaluation, Laboratory Diagnosis, and Diagnostic Algorithms using Musculoskeletal Ultrasound (MSUS)

Abstract

Abstract: Limping refers to an asymmetrical gait that deviates from the typical gait pattern ex- pected for a child of a certain age. In most children, limping is caused by a mild, self-limiting event, such as a contusion, strain, or sprain. However, a child's limping is always a pathological finding that poses a particular diagnostic challenge and necessitates a thorough assessment. The pediatrician must weigh a wide range of acute and chronic potential causes of a non-traumatic limp, including infection, neoplasia, and chronic inflammatory disorders. A thorough history and clinical examina- tion will help us arrive at the correct diagnosis. Understanding the typical gait is essential to recog- nizing and correctly interpreting the disordered one. The examination of child limping involves us- ing a variety of diagnostic methods. Efficient and cost-effective diagnosis and treatment of the un- derlying condition requires a systematic approach. This review provides the pediatric rheumatolo- gist perspective and approach for evaluating non-traumatic limp in children, with a focus on the use of point-of-care (PoC) musculoskeletal ultrasound (MSUS) as a crucial tool in daily practice.