Differential Diagnosis for a 7-year-old child with a 2-week history of limp
- Single most likely diagnosis:
- Transient Synovitis: This is a common condition in children, characterized by inflammation of the synovial membrane in the hip joint, often following a viral infection. It typically presents with a sudden onset of hip pain and limp, which can resolve on its own within a few days to weeks.
- Other Likely diagnoses:
- Legg-Calve-Perthes Disease: A condition where the blood supply to the head of the femur is disrupted, leading to necrosis of the bone. It typically affects children between 4-10 years old and presents with a gradual onset of hip pain and limp.
- Slipped Capital Femoral Epiphysis (SCFE): A condition where the growth plate in the hip joint becomes weakened, causing the femoral head to slip out of place. It is more common in obese children during periods of rapid growth and presents with hip pain, limp, and limited range of motion.
- Osteomyelitis or Septic Arthritis: Although less common, these infections can cause severe pain, swelling, and limp. They are more likely to present acutely rather than over a 2-week period but should be considered, especially if there's a history of trauma or fever.
- Do Not Miss diagnoses:
- Malignancy (e.g., Osteosarcoma, Ewing's Sarcoma): Although rare, bone cancers can present with pain and limp. Early detection is crucial for effective treatment, making it essential not to miss these diagnoses.
- Neuromuscular conditions (e.g., Muscular Dystrophy): Conditions like Duchenne Muscular Dystrophy can initially present with a limp due to muscle weakness.
- Inflammatory conditions (e.g., Juvenile Idiopathic Arthritis): These conditions can cause joint pain and swelling, leading to a limp.
- Rare diagnoses:
- Congenital conditions (e.g., Hip Dysplasia): Although often diagnosed earlier in life, some cases might not become apparent until later in childhood, presenting with a limp.
- Hematologic conditions (e.g., Sickle Cell Disease): Certain conditions can lead to bone infarcts or other complications causing pain and limp.
- Infections (e.g., Lyme Disease, Tuberculosis): Uncommon causes of limp in children, especially in endemic areas or with specific exposure histories.