Limps

My son seems to be limping. Should I call my pediatrician?

Limping in a child can be caused by something as simple as a stone in the shoe, a blister on the foot, or a pulled muscle. But a limp also can be a sign of more serious trouble, such as a broken bone or an infection, so it should be investigated early to make sure no serious problems are present.

Some children limp when they first learn how to walk. Among the causes of early limping are neurological damage (e.g., cerebral palsy). Any limp at this age needs to be investigated as soon as possible, since the longer it goes untreated, the more difficult it may be to correct. Once walking is well established, significant sudden limping usually indicates one of several conditions:

Fractures

A toddler fracture is a so-called spiral fracture of the tibia (the leg bone extending from the knee to the ankle) that can occur with minor accidents such as a slip on a newly waxed floor or a jump from a porch step or swing. The bone fracture itself occurs in a spiral or twisted pattern. Sometimes the child can explain how the injury occurred, but youngsters do so many things in one day that they may have difficulty recalling exactly what happened. Sometimes an older sibling or babysitter can solve the mystery.

Infection

Hip problems that cause a limp at this age usually are due to a viral joint infection and need to be brought to the attention of your pediatrician. When a child has an infection in the bone or joint, there usually is fever, swelling of the joint, and redness. If the infection is in the hip joint, the child will hold her leg flexed or bent at the hip and be extremely irritable and unwilling to move the hip and leg in any direction.

Hip problems

Sometimes a child is born with a dislocated hip (DDH) that, in rare cases, goes undetected until she starts to walk. As one leg is shorter than the other, the child will walk with an obvious limp, which will be persistent.

Treatment

If you know that your child?s limp is due to a minor injury, such as a blister, cut, splinter in the foot, or mild sprain, you can apply simple first-aid treatment at home. However, most other causes need to be examined and treated by a physician.

If your child has just started walking and is limping, the pediatrician should see her as soon as possible. Calls about limping in an older child may be delayed for twenty-four hours, since many of these problems disappear overnight.

X rays of the hip or the entire leg may be necessary to make the diagnosis. This is most certainly true if there is a suspicion of developmental dysplasia of the hip. Depending on the diagnosis, the following treatments may be necessary:

 

Published online: 6/07

Source: Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2004 American Academy of Pediatrics, Updated 5/05)
To order a copy of this book visit the AAP Bookstore.
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