Differential Diagnosis for Toe Walking

Single Most Likely Diagnosis

• Idiopathic Toe Walking: This is the most common cause of toe walking in children, often presenting without any underlying neurological or orthopedic condition. It is usually diagnosed when other causes are ruled out.

Other Likely Diagnoses

• Cerebral Palsy: A group of disorders that affect movement and muscle tone, often presenting with toe walking due to spasticity in the calf muscles.
• Muscle Imbalance: Tightness in the Achilles tendon or calf muscles can lead to toe walking.
• Autism Spectrum Disorder: Some children with autism may exhibit toe walking as part of their sensory or motor profile.
• Developmental Delay: Children with developmental delays may have toe walking as part of their gross motor delay.

Do Not Miss Diagnoses

• Duchenne Muscular Dystrophy: A genetic disorder characterized by progressive muscle degeneration, which can initially present with toe walking among other symptoms.
• Spinal Dysraphism: A congenital condition affecting the spine that can lead to neurological symptoms, including toe walking.
• Tumor or Infection Affecting the Spine or Brain: Although rare, conditions such as spinal cord tumors or infections can cause toe walking and are critical to diagnose early.

Rare Diagnoses

• Charcot-Marie-Tooth Disease: A group of inherited disorders that affect the peripheral nerves, potentially leading to toe walking due to muscle weakness.
• Friedreich's Ataxia: A rare genetic disease causing progressive damage to the nervous system, which can include toe walking among its symptoms.
• Rett Syndrome: A rare genetic disorder that affects brain development, leading to severe mental and physical disability, and can include toe walking in its presentation.