title: LIMPING IN CHILDREN.
abstract: Limping in children is a common complaint at pediatric, pediatric orthopaedic offices and in emergency rooms. There are several causes for this condition, and identifying them is a challenge. The older the patient, the better the anamnesis and more detailed the physical examination will be, enabling an easier medical assessment for searching the source of the disorder. In order to make the approach easier, three age groups can and should be considered. Among infants (1 to 3 years old), diagnosis will most likely be: transitory synovitis, septic arthritis, neurological disorders (mild brain palsy (BP) and muscular dystrophy), congenital hip dislocation (CHD), varus thigh, juvenile rheumatoid arthritis (JRA) and neoplasias (osteoid osteoma, leukemia); in the scholar age group, between 4 and 10 years old, in addition to the diagnoses above, Legg-Calvé-Perthes disease, discoid meniscus, inferior limbs discrepancy and unspecific muscular pain; in adolescents (11 to 15 years old): slipped capital femoral epiphysis, congenital hip dislocation, chondrolysis, overuse syndromes, dissecans osteochondritis, and tarsal coalition. The purpose of this study is to provide an update on how to approach pediatric patients presenting with limping, and to discuss its potential causes.
authors.affiliation: Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas, Santa Casa de Sao Paulo; Assistant Physician, Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Santili
authors.affiliation: Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Wilson Lino
authors.initials: WL
authors.lastname: Júnior
authors.affiliation: Interning Physician, Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Ellen de Oliveira
authors.initials: Ede O
authors.lastname: Goiano
authors.affiliation: Resident (R3) Physician, Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas, Santa Casa de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Romero Antunes Barreto
authors.initials: RA
authors.lastname: Lins
authors.affiliation: Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Waisberg
authors.affiliation: Master in Orthopedics, Faculdade de Ciências Médicas, Santa Casa de Sao Paulo; Physician, Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Susana Dos Reis
authors.initials: Sdos R
authors.lastname: Braga
authors.affiliation: Head, Pediatric Orthopedics and Traumatology Group, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Akkari
keywords: Arthritis, Infectious; Arthritis, juvenile rheumatoid; Cerebral palsy; Child; Gait; Hip; Intermittent claudication; Legg-Perthes disease; Osteochondritis dissecans; Synovitis