Legg-Calve-Perthes (Limp)


Limp
  • In the ED evaluation of a child with limping, careful history taking and physical examination are key.
  • X-rays are usually needed, often of the entire affected extremity; other ancillary studies may include blood cultures, CBC with differential, ESR, CRP.
  • The differential diagnosis can often be narrowed based on age, history of trauma, and/or likelihood of infectious causes.
  • Few of the more common causes are listed; other causes include
    • Nutritional deficiencies (eg, rickets),
    • Fractures (eg, toddler’s fractures, avulsion fractures, stress fractures),
    • Sprains/contusions,
    • JRA,
    • Osteomyelitis, and
    • Neoplasms (Ewing’s sarcoma, osteogenic sarcoma, leukemia)

LEGG-CALVE-PERTHES:

SYMPTOMS/EXAM

DIAGNOSIS

TREATMENT