This website uses cookies to give you the best experience. By continuing to use this website you are consenting to cookies being used. You can delete and block cookies from within your browsers settings. For more information please refer to our privacy and cookie policy page.

Continue

Inflammatory Conditions

Limp can be a feature of inflammatory joint or muscle disease.

The limp may be acute, intermittent or insidious. There may be regression of acquired motor milestones. Where a limp is not resolving or intermittent, then there needs to be suspicion of inflammatory disease and referral to paediatric rheumatology is warranted.  

The clinical assessment is key, noting that young children may not localise pain and non-verbal signs of discomfort need to be looked for. 

Inflammatory joint disease - The commonest cause is Juvenile Idiopathic Arthritis - Making a diagnosis can be difficult as pain may be non-verbalised and blood tests (full blood count and acute phase) may be normal, and rheumatoid factor is usually absent. Radiographs are usually normal - so the diagnosis can be easily missed. Any suspicion should warrant referral to paediatric rheumatology. 

Inflammatory muscle disease - The commonest cause is Juvenile Dermatomyositis (JDM).  The skin changes may be subtle and easily missed. The child with JDM is proximally weak and Gowers sign is likely to be present (see pREMS - Hip). The school-aged child who cannot jump warrants concern about proximal weakness. Any suspicion should warrant referral to paediatrics, paediatric neurology or paediatric rheumatology. 

Other muscle diseases can present with limp (e.g., inherited myopathies) but the history is usually of delayed milestones (walking or development).

Site Statistics

To date (end of November 2018) pmm has >392,000 hits and >146,000 users from 205 countries!

Why register?

Some parts of pmm which involve pictures or videos of children, can only be viewed by registered users. Registering also allows you to bookmark favourite pages and track your viewing.

find out more

Short online courses

from Newcastle University, UK

e-resources from PMM

pmm for you

Please help us ensure pmm is as useful to you as possible by completing this short survey

complete survey