Pediatric emergency medicine trisk 0907 0907
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FIGURE 46.1 Algorithmic approach to the child with a limp. AVN, avascular necrosis; CBC,
complete blood cell count; CRPS, complex regional pain syndrome; DDH, developmental
dysplasia of the hip; LCP, Legg–Calvé–Perthes disease; SCFE, slipped capital femoral
epiphysis.
Systemic bone or soft tissue involvement can lead to limping without
localization of limb findings. A painful limp without localization or with
migratory bone pain may suggest a hematologic or oncologic cause, such as
sickle cell disease or leukemia. Limping with bilateral leg pain localized to the
muscles, especially the calves, suggests myositis. Benign acute childhood
myositis is common during influenza epidemics. Recurrent diffuse aches after
