- duration and progression of limp? - getting better or worse?
- recent trauma and mechanism? -stumbling
- associated pain and characteristics? when is it worse? help focus on the mechanism..
- interference in daily life..
- important events - trampoline, bouncy castle, skateboarding..
Antalgic gait:
- painful limp
- cautious gait of a child with back pain
- diskitis
- complete refusal to walk
- (causes) trauma,overuse syndrome,synovial inflammation-JIA,infection, perthes disease, SUFE
Equinus gait
- toe walking or 'toe-to-heel'
- (causes) calf muscle contracture
- cerebral palsy
- late presentation DDH
- late presentation PTEH
- idiopathic
Tredelenburg's sign/gait due to weak hip abductor on the opposing thigh..
Circumduction gait
- painful foot condition
- functional or structural inequalities of legs
Other areas:
-meningococcal septicaemia presenting purpura
-cutaneous marker of occult spinal dysraphism
-marks of domestic abuse
-appendicitis = referred pain to hip due to relation to obturator internus m. and iliacus m.
Location of pain when complaining;
=>hip,knee, not localised, leg in general or back.
INVESTIGATION:
- MRI
- plasma viscosity
- ESR(erythrocyte sedimentation rate)
- ultrasound (hip effusion - fluid presence in case of infection)
- joint aspiration (hip effusion, inflammed knee
- X-ray
- C-reactive protein
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