title: Toe walking as a presenting sign of systemic lupus erythematosus.
abstract: Toe walking is a previously unreported presentation of systemic lupus erythematosus (SLE). We describe a patient who presented with profound multisystem involvement that was preceded by one month of toe walking and multiple flexion contractures without arthritis. Her lupus is now under control after aggressive therapy, yet she continues to struggle with tendinopathy despite continued physical and occupational therapy. Lupus should be considered in the appropriate clinical context in children who have new-onset contractures due to tight tendons.
authors.affiliation: The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA basiagam@email.chop.edu.
authors.forename: M
authors.initials: M
authors.lastname: Basiaga
authors.affiliation: The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: D
authors.initials: D
authors.lastname: Sherry
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000628:therapy*; D008775:Methylprednisolone / Q000008:administration & dosage; D009788:Occupational Therapy / Q000379:methods; D026741:Physical Therapy Modalities; D052256:Tendinopathy / Q000209:etiology* / Q000534:rehabilitation; D014034:Toes; D016138:Walking
chemical_list: D008775:Methylprednisolone
keywords: Lupus; contracture; musculoskeletal; tendon; toe walking