Common Pediatric MSK Concerns


Did the limp develop suddenly or gradually, or has it always been there?

This question is part of the history. Consider the following questions that you may ask:

  1. When was the limp first noted?
  2. Is there a history of recent trauma?
  3. Has the limp changed over time?
Sudden (or "acute") onset points the diagnosis towards trauma or acute infection as potential sources. Chronic and gradually worsening limping may signal inflammatory, mechanical, neurologic or neoplastic disorders. It is important to determine if the child has ceased to participate in activities he or she enjoys (e.g. sports, playing at the park) as this is a clue to a more significant disorder. If deteriorating motor milestones are noted, suspect a neurological or muscle disorder (cerebral palsy and muscular dystrophy are examples of this).

2 year old with septic left hip
Image source: L. Davidson