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ECR 2019 / C-1429
Role of imaging in a limping child
Congress: ECR 2019
Poster No.: C-1429
Type: Educational Exhibit
Keywords: Congenital, Education, MR, Paediatric, Bones
Authors: S. A. M. Ibrahim1, T. Salem Alyafei1, N. M. Saloum2, M. Sabawi1; 1Doha/QA, 2Doha, Doha/QA
DOI:10.26044/ecr2019/C-1429

Background

Limp is defined as an uneven, jerky, or laborious gait, usually caused by pain, weakness, or deformity. Limping in a child can arise from the hip /lower limbs pathology or from remote sites including the spine, abdomen, or pelvis).

Limping in children is fairly common. The list of potential etiologies is long, varied and ranges from benign to life-threatening. Once a gait abnormality has been identified, a thorough history and physical examination if needed should be undertaken to narrow the differential diagnosis. Patients often have tenderness or loss of range of motion at the site of pathology. Further laboratory and radiographic studies are obtained according to the findings from the history and physical examination. Various pathologies are responsible for limping in children. The management varies from reassurance to major surgery depending upon the cause


Differential diagnosis:

Infection (arthritis, Osteomyelitis, discitis, epidural abscess, psoas abscess, appendicitis. retroperitoneal abscess, iliac adenitis, lower extremity cellulitis)

Inflammatory (Transient synovitis and juvenile idiopathic arthritis, PVNS)

Trauma (Toddler/spiral, foot and stress fractures and non-accidental injuries

Developmental and other Bone disorders (Developmental dysplasia of the hip (DDH),slipped upper femoral epiphysis (SUFE),Tarsal coaliation , skeletal dysplasias, limb length discrepancies)

Osteonecrosis (LeggeCalveePerthes’ disease, osteochondritis dissecans, sickle cell anaemia)

Osteochondrosis and Apophysitis (Kohler ,Freiberg ,sever ,Sinding-Larsen- Johansson,Osgood- Schlatter diseases.

 

Tumors:

-Malignant :Ewing’s sarcoma, osteosarcoma, metastases (neuroblastoma), leukaemia, lymphoma, Langerhan’s cell histiocytosis.

 

-Benign lesions: Osteoid osteoma, bone cyst, chondroblastoma, exostosis, osteoblastoma

Neuromuscular disorders

 

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