Fifteen-minute consultation: The limping child

Adamson, Jonathan; Waterfield, Thomas

doi:10.1136/archdischild-2018-315905

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…È necessario porre domande riguardanti la presenza e la sede riferita del dolore, nonché le condizioni che lo accentuano o alleviano, la risposta a eventuali farmaci assunti. Riguardo alla storia recente è opportuno chiedere se il bambino ha avuto infezioni, precedenti episodi di zoppia o dolore in altre sedi articolari o ossee, calo ponderale, astenia, diatesi muco-cutanea, rigidità mattutina [5].…”

Section: Approccio Clinicounclassified

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Il bambino che zoppica in pronto soccorso

Brusadelli,

Marino

2024

QACP

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Lameness is a frequent reason for admission to the pediatric emergency department. Evaluation of the limping child can be complex for the clinician. In most cases these are benign causes, however, it is necessary to take into consideration which diagnoses should not be overlooked. Lameness presents a challenge to the pediatrician, who must seek a balance between the need to identify serious conditions early and avoid unnecessary potentially invasive and harmful investigations. Therefore, a possible diagnostic approach for use in the emergency department aimed at early identification of the most serious etiologies is described

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Section: Approccio Clinicounclassified

“…La valutazione clinica deve essere completata con l'esame obiet-Tabella 2. Cause più frequenti di zoppia suddivise per età di presentazione (modificata da [3,5])…”

Section: Esame Obiettivounclassified

Il bambino che zoppica in pronto soccorso

Brusadelli,

Marino

2024

QACP

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“…Several studies have proposed different algorithms for differential diagnosis and management of limping in pediatric patients, based on either clinical signs, blood markers or imaging findings, but still with no consensus on the best approach and no validated risk prediction tools [5][6][7][8][9][10][11][12][13][14][15] aside from only a few studies focused on the PED setting [4,12,16].…”

Section: Introductionmentioning

confidence: 99%

“…We identified the following as "crippling/severe conditions" those etiologies needing medical evaluation and therapy as soon as possible in order to prevent potential sequelae, including oncologic etiologies, bone or neurological infections and other pathologies such as epiphysiolysis, Perthes disease, Guillain Barrè syndrome and non-accidental injuries [2,14].…”

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confidence: 99%

Atraumatic Limping Child, a Challenge for Pediatricians: An Observational Age-Related Study in a Pediatric Emergency Department

Cristaldi,

Boni,

Ferro

et al. 2024

Children

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Background: Atraumatic limping is a frequent cause of consultation in Pediatric Emergency Departments (PED) and often represents a challenge for pediatricians for its variability in etiology ranging from benign causes to potential crippling conditions. The aims of this research are to illustrate the clinical features of acute limping children (LC) and to identify the possible red flags that could help to make a diagnosis of severe pathologies. Methods: We carried out a retrospective study about non-traumatic limping children referred to the PED of Bambino Gesù Children’s Hospital over a 2-year period. We divided the cohort into three groups based on the patient’s age: toddlers, children and adolescents. We considered crippling conditions: oncologic etiologies, bone or neurological infections, epiphysiolysis, Perthes disease, Guillain Barrè syndrome and non-accidental injuries. Results: We analyzed 485 patients. At clinical evaluation, 19.5% of the patients presented at least one sign and/or symptom of red flags. Crippling conditions (6.2% of the total population) showed red flags in 36.7%. Transient synovitis of the hip was the most frequent diagnosis. We found crippling conditions in 30 patients, mostly represented by toddlers. Conclusions: Our data suggest that toddlers and patients presenting red flags should be evaluated with particular suspicion because they have an increased risk of underlying severe conditions.

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“…Owing to the particularity of children, outpatient doctors in clinics typically employ the visual method to make qualitative judgments, which mainly depend on their subjective experiences ( 4 ). This approach often leads to missed diagnosis of the disease, and it is impossible to give a quantitative basis for diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Clinical reliability and validity of a video-based markerless gait evaluation method

Lin,

Wang,

Sha

et al. 2023

Front. Pediatr.

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ObjectiveTo explore the reliability and validity of gait parameters obtained from gait assessment system software employing a human posture estimation algorithm based on markerless videos of children walking in clinical practice.MethodsEighteen typical developmental (TD) children and ten children with developmental dysplasia of the hip (DDH) were recruited to walk along a designated sidewalk at a comfortable walking speed. A 3-dimensional gait analysis (3D GA) and a 2-dimensional markerless (2D ML) gait evaluation system were used to extract the gait kinematics parameters twice at an interval of 2 h.ResultsThe two measurements of the children's kinematic gait parameters revealed no significant differences (P > 0.05). Intra-class correlation coefficients (ICC) were generally high (ICC >0.7), showing moderate to good relative reliability. The standard error of measurement (SEM) values of all gait parameters measured by the two walks were 1.26°–2.91°. The system software had good to excellent validity compared to the 3D GA, with ICC values between 0.835 and 0.957 and SEM values of 0.87°–1.71° for the gait parameters measured by both methods. The Bland–Altman plot analysis indicated no significant systematic errors.ConclusionsThe feasibility of the markerless gait assessment method using the human posture estimation-based algorithm may provide reliable and valid gait analysis results for practical clinical applications.

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Fifteen-minute consultation: The limping child

Cited by 9 publications

References 19 publications

Il bambino che zoppica in pronto soccorso

Il bambino che zoppica in pronto soccorso

Atraumatic Limping Child, a Challenge for Pediatricians: An Observational Age-Related Study in a Pediatric Emergency Department

Clinical reliability and validity of a video-based markerless gait evaluation method

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