title: Diagnostic utility of lower extremity radiographs of young children with gait disturbance.
abstract: The diagnostic utility of lower extremity radiographs was evaluated using 84 outpatients 1 to 5 years of age with gait disturbance whose lower extremities appeared physically normal. Chief complaints included limp (65 children [77%]), refusal to walk or stand (37 children [44%]), and frequent falling (6 children [7%]). A total of 43 children (51%) had more than one complaint. The mean age of patients was 26 months and the median duration of symptoms was 1 day. Trauma was reported in 43 (51%) cases and fever in 14 (17%). Results of radiographical studies appeared normal in 81 children (96%), demonstrated soft tissue swelling in 2 children, and revealed a bony island in 1 child. In 1 patient admitted to the hospital for failure to thrive and irritability, and whose radiographic results appeared normal, findings consistent with osteomyelitis later developed. Of the remaining children, 68 (81%) were available for follow-up observation 4 to 28 months after the initial visit and all reported spontaneous resolution of the initial complaint. It was concluded that in a well-appearing child with an otherwise normal physical examination results, an acute gait disturbance is likely to be a self-limiting condition and radiographs are unlikely to contribute to the diagnosis.
authors.affiliation: Ambulatory Care Center, Children's Hospital of Pittsburgh, Pennsylvania.
authors.forename: S D
authors.initials: SD
authors.lastname: Blatt
authors.forename: B M
authors.initials: BM
authors.lastname: Rosenthal
authors.forename: D C
authors.initials: DC
authors.lastname: Barnhart
mesh_terms: D002675:Child, Preschool; D005260:Female; D005684:Gait; D006801:Humans; D007223:Infant; D007866:Leg / Q000000981:diagnostic imaging*; D008297:Male; D009069:Movement Disorders / Q000209:etiology*; D010019:Osteomyelitis / Q000000981:diagnostic imaging; D010808:Physical Examination; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors