The Limping Child: A Systematic Approach to

Diagnosis

Table 1.
Differential Diagnosis of Limping in Children

Bone conditions

Benign neoplasm

Osteoblastoma

Osteoid osteoma

Congenital condition

Clubfoot

Congenitally short femur

Developmental dysplasia of the hip

Developmental condition

Legg disease

Slipped capital femoral epiphysis

Infection

Osteomyelitis
Limb length discrepancy

Malignant neoplasm

Ewing sarcoma

Leukemia

Osteosarcoma

Osteonecrosis

Sickle cell disease

Overuse injury

Osteochondritis dissecans

Stress fracture

Trauma

Child abuse

Fracture (toddler’s fracture)

Intra-abdominal conditions

Appendicitis

Neuroblastoma

Psoas abscess

Intra-articular conditions
Congenital condition

Discoid lateral meniscus

Hemarthrosis

Hemophilia

Trauma

Infection

Gonorrhea

Lyme disease

Septic arthritis

Inflammation

Acute rheumatic fever

Juvenile rheumatoid arthritis

Reactive arthritis

Systemic lupus erythematosus

Transient synovitis

Trauma

Intra-articular injury

Neuromuscular conditions
Cerebral palsy

Meningitis

Muscular dystrophy

Myelomeningocele

Soft tissue conditions

Congenital condition

Idiopathic tight Achilles tendon

Infection

Cellulitis

Pyomyositis or viral myositis

Soft tissue abscess

Overuse injury

Chondromalacia patellae

Jumper’s knee

Osgood-Schlatter disease

Sever disease

Trauma

Child abuse
 Foreign body

Sprains and strains

Spinal conditions

Diskitis

Spinal cord tumors

Vertebral osteomyelitis

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