Why is my child limping?
Most children whom are limping with no injury will have an ‘irritable hip’ (see below) or another condition which does not need tests to diagnose. These will get better on their own without hospital treatment.
There are some other more serious causes of a limp such as joint or bone infection which do need hospital treatment. The clinician who has assessed you child will have ruled out these more serious causes by taking a history and examining your child carefully.
What is an irritable hip?
Irritable hip (or transient synovitis) is the commonest cause of limp in childhood. It is due to inflammation (not infection) of the hip joint. The exact cause is not known but it often happens after a viral illness or an injury.
Your child may complain of pain in the hip, groin, thigh or knee and may have difficulty walking or crawling. Usually only one side is affected. It is generally a mild condition which gets better on its own after one or two weeks.
Does my child need to be seen again?
Most children who attend A&E or their GP with a presentation of limp will get better with only simple interventions such as pain relief, and further investigation is often not required.
If the symptoms are not improving in three to five days then investigations may be needed to understand the cause of the limp.
If required you will be given a scheduled appointment with one of the paediatric emergency department advanced clinical practitioners. At this appointment your child will be re-examined, and if necessary, further investigations may be complete such as blood tests /ultrasound scans/x-rays.
Scheduled appointments
Scheduled appointments take place at:
- Paediatric emergency department, B Floor Jubilee Wing, Leeds General Infirmary.
- Please notify the emergency department reception on arrival and inform of clinic appointment to confirm attendance.
- Should your child’s symptoms have improved before your clinic appointment – please call the ED Admin Team (please see contact details below) to cancel your appointment.
You should return as an emergency to Paediatric ED if your child develops the following symptoms as these are symptoms that may indicate a more serious problem:
- Your child becomes unwell.
- Your child develops a high temperature.
- Your child is unable to put any weight at all on the affected leg despite pain relief.
- Your child develops night pain or night sweats.
- You are unable to manage your child’s pain despite regular over the counter pain relief.
What can I do to help my child at home?
You should encourage your child to rest the affected leg as much as possible over the next few days, but they can gently mobilise at home as normal. This may mean that your child does not attend school or nursery until the clinic appointment if they are finding mobility difficult.
Children should be given regular pain relief, and ideally regular Ibuprofen, which can be given every 6-8 hours (no more than three times in 24 hours). If your child is not able to take Ibuprofen due to other health problems or allergies then Paracetamol can be used (up to four times per day).
Important
Always follow the dose prescribed or detailed on the medication.
Most children will show some improvement over the next few days.
When can I expect my child to be back to normal?
You can allow your child to gradually go back to their usual activities as they improve, but we would advise that they do not do sport or strenuous activity for two weeks. Your child may still need pain relief medicine as required. Gradually reduce the number of times you give it in a day as they get better.
We would expect your child to be back to normal within one to two weeks, however in some cases symptoms may persist up to four weeks.
If your child is not back to normal mobility by four weeks – please contact the Paediatric ED admin team or email the PED ACP team to book back into Paediatric review clinic. At this appointment we will discuss with you whether it may be necessary to refer your child to a specialist doctor who deals with children’s bones and joints.
It may be helpful to take a paper copy of this leaflet with you.
