The Limping Child

Limping in children functions as a clinical symptom rather than a diagnosis, requiring a systematic, age-based evaluation to differentiate between benign conditions and urgent pathologies. Children under three years old typically present with trauma or congenital issues, while those aged three to ten often exhibit transient synovitis, and older children face risks like slipped capital femoral epiphysis or systemic disease. Effective assessment prioritizes a thorough history and physical examination, including gait observation and careful inspection of the feet to rule out simple mechanical causes like splinters. When evaluating for septic arthritis, the Kocher criteria—incorporating fever, weight-bearing status, inflammatory markers, and white blood cell counts—provide a validated framework for risk stratification. While ultrasound identifies joint effusions, it does not rule out infection, necessitating clinical judgment and potential joint aspiration in high-risk cases.