Limping in children


Limping in children


If a child is limping, it will usually be because of a minor injury such as a sprain or splinter. However, if there's no obvious cause, see your GP as there may be a serious underlying medical condition. 

Advice for parents

If your child has started limping,if they injured their leg or foot or trod on something sharp. Inspect the soles of their feet and in between their toes for a wound or blister. You may need to take your child to a minor injury unit or, if the injury is severe, to your nearestaccident and emergency (A&E) department. 

If there's no wound or sign of injury, your child may have an underlying medical condition that will need to be thoroughly investigated by your GP. This will usually be done by arranging blood tests and an X-ray of your child's hip.

If your child also has a fever, take them to your GP as soon as possible. They will need to be seen urgently by a specialist so that a bone infection can be ruled out. If they seem unwell and won't put any weight on the leg, take them to A&E.

Read on to learn about some of the likely medical causes of your child's limp. However, it's important not to diagnose the cause yourself – always leave that to a doctor.

Childhood medical conditions that cause a limp

The most common medical causes of an unexplained limp in a child are:

Irritable hip.

A severe viral infection.

Juvenile arthritis.

A bone or joint infection.

Movement in the growth plate of the hip (slipped upper femoral epiphysis).

These, and some of the more unusual causes, are explained in more detail below.

Irritable hip

Irritable hip (also known as transient synovitis) is a common childhood condition that causes hip pain and limping. Children with irritable hip may also be reluctant to place weight on the affected hip joint, making it difficult for them to stand or walk.

The condition occurs when the lining that covers the hip joint becomes inflamed, although the cause of inflammation is unclear. 

A diagnosis of irritable hip is only made after other more serious causes of a limp are ruled out.

Severe viral infection

Some viral infections can cause painful joints. If your child has a fever and pain in many joints, as well as a limp, they are likely to have a viral infection. However, make sure you see your GP for a proper diagnosis as they will want to rule out more serious bone infections, such as:

Septic arthritis – a bacterial infection of a joint that severely restricts movement and needs urgent treatment with surgery and antibiotics. This is more common in children under the age of 2.

Osteomyelitis – a bacterial infection of the bone, which is more common in children than adults. Treatment is in the form of antibiotics and surgery is occasionally needed.

Juvenile arthritis

Arthritis is often associated with older people, but can sometimes affect children. This is known as juvenile arthritis.

Arthritis causes pain and inflammation (swelling) of the joints and bones. A child with juvenile arthritis will feel stiff, especially first thing in the morning, and will not be able to move their joints freely.

There is no cure for arthritis, but there are treatments that can slow down the condition and help to control the symptoms.

Movement of the hip's growth plate (slipped upper femoral epiphysis )

Slipped upper femoral epiphysis (where the growing part of the bone in the hip joint moves) is more common in adolescents. This usually happens gradually over time, and tends to affect older children, although it can suddenly happen as the result of an injury.

If your child has a slipped upper femoral epiphysis, they should avoid walking or rotating the leg and will need to have surgery as soon as possible, to realign the bone and fix it into position.

Other causes of a limp

Perthes disease – a problem in the top of the hip, causing the bone to grow abnormally. This is not an emergency, but is painful and may require surgery.

Scoliosis – abnormal curvature of the spine that can cause the child to lean to one side.

Developmental dysplasia of the hip – an abnormal or dislocated hip that occurred before birth or developed soon after birth.

Severe pain in the lower abdomen – this can becaused byappendicitis.

Unequal leg lengths – which has a wide variety of causes.

A disease affecting the nerves – such as cerebral palsy.