The medical history (history of illness) represents an important component in the diagnosis of the limping child. Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic medical history (somatic and … Limping Child: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Hip dysplasia (maldevelopment of the acetabulum). Endocrine, nutritional, and metabolic diseases (E00-E90). Rickets – disorder of bone metabolism in children leading to marked demineralization of bone (“bone softening”) and skeletal changes due to retardation of bone growth. Cardiovascular system (I00-I99). Rheumatic fever – specific reaction that occurs after … Limping Child: Or something else? Differential Diagnosis
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait (fluid, limping). Body or joint posture (upright, bent, gentle posture). Malpositions (deformities, contractures, shortenings). … Limping Child: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Differential blood count Inflammatory parameter – CRP (C-reactive protein) Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification. Electrolytes – calcium, phosphate Alkaline phosphatase [↑ in combination with Ca ↓, phosphate ↓ → … Limping Child: Test and Diagnosis
Obligatory medical device diagnostics. Sonography (ultrasound) of the hip Conventional x-rays of the hip joint, etc. – in cases of suspected e.g. Fracture (bone fracture), hip dislocation (dislocated hip joint), epiphysiolysis capitis femoris (femoral head dislocation), Perthes disease (aseptic bone necrosis (necrosis (tissue death) of bone that occurs in the absence of infection (“aseptic”) due … Limping Child: Diagnostic Tests
The following symptoms and complaints may occur together with child limping (limping child): Leading symptom Limping child or limping child. Associated symptoms Fever Morning stiffness Pain in one or more joints (arthralgia/joint pain). Warning signs (red flags) Young (about > 9 years of age) + weight problems (children are or were usually very obese (5.9-fold … Limping Child: Symptoms, Complaints, Signs
