Limping in Children

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If a child is limping, the limp is usually due to a minor injury such as a sprain or splinter. But if there’s no obvious cause, see your GP as it may indicate a serious underlying medical condition.

Advice for parents

If your child has started limping, find out 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 nearest accident 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, usually by arranging blood tests and an X-ray of your child’s hip.

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

In the meantime, you can read on to learn about some of the likely medical causes of your child’s limp. But it’s important not to diagnose your child yourself – always leave that to your doctor.

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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

• the thigh bone slipping from the hip socket (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 irritible 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

Causes

Many things can cause a limp – some are painful and some aren’t. The most likely causes of limping will vary according to the age of your child.

Simple and usually obvious causes include bruising to your child’s leg or foot, a tight shoe, or a wart on the sole of your child’s foot.

In preschoolers, the commonest cause of limp is a viral infection. This is called ‘irritable hip’.

More serious causes of limping might include a broken bone (fracture), cerebral palsy, a bone or joint infection, or arthritis. Bone tumours can also cause a limp, but these tumours are rare.

Symptoms

LC3 201x300 Limping in ChildrenYour child will walk by favouring her good leg. She’ll put as little weight as possible on the leg that causes her pain. Pain is usually generalised, but she might be able to point to the painful area.

A limp can alter the way your child’s muscles work and might cause them to ache because they’re under increased strain. If the limp is caused by an infection, your child will usually have a fever, and he’ll be irritable and feeding poorly.

When to see your doctor

If your child limps for more than a day and there’s no obvious cause (for example, a tight shoe), see your doctor as soon as possible.

You should also see your doctor if:

• your child has an unexplained fever

• your child refuses to walk at all

• there’s obvious swelling of part of the hip or leg, especially around a joint.

Treatment

Treatment for a limp depends on its cause, but will usually involve pain relief.

Depending on your child’s symptoms, your doctor might order some blood tests or some imaging of your child’s affected limb (including an X-ray, an ultrasound or even a bone scan).

For minor injuries, rest might be all your child needs. For more serious problems, your doctor might refer your child to a specialist for further assessment.

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