Sometimes parents notice that a child who was walking upright suddenly begins to limp on one leg. A lot of questions and suspicions immediately arise. We will try to describe in detail how to understand what exactly is happening to the child in this article.
Peculiarities
Lameness in medicine is usually called changes in gait that are accompanied by asymmetry in the position of the legs. Lameness usually develops as a result various lesions musculoskeletal system. One or another pathology leads to the development of a lame gait lower limbs.
A child may begin to limp suddenly, at first glance, without visible reasons. But if you look into this problem, it will become obvious - No one ever succeeds in limping for no reason.
It is very difficult to simulate lameness, at least to do it for a long enough time, because having forgotten, the child will begin to reflexively make the correct movements of the limbs and not a trace of the lameness remains.
Lameness is always associated with limited movement or pain syndrome when there is a load on the leg (on joints, tendons, ligaments, muscles). If there is pain, the person again reflexively tries to eliminate it by sharply reducing this load. This results in an asymmetrical, “lame” gait. If parents notice that the child is limping on one leg, they need to find the reason as soon as possible that forces the baby to reduce the load on the leg.
Possible reasons
The search for the cause that caused lameness can be lengthy, especially if the child is small and cannot yet tell himself what preceded the onset of pain. Parents should sit or lay the child down, remove his shoes, socks and pants and examine the limb very carefully. It is clear that not all reasons may be obvious and noticeable, but an inspection will reveal at least the simplest of them and eliminate the inconvenience.
A baby may limp due to:
- Uncomfortable, constricting, pinching or chafing shoes. In this case, you may notice calluses or pressure on your feet and toes.
- Injuries or inflammatory process feet. It could be a splinter, an abscess, an insect bite. The baby could prick his heel or fingers with a sharp object. A foreign body could have entered under the nail.
- Joint diseases. More often in children under 15 years of age, so-called transient synovitis occurs - inflammation of the joint - knee or hip. It manifests itself precisely as lameness. Children can sometimes develop arthritis. In this case, lameness will be the final manifestation of an illness that began long ago - with a viral infection or severe allergy.
- Age-related pathologies . These include completely harmless physiological pains that appear against the background of too much rapid growth bones and strains of ligaments that cannot keep up with them, and serious and dangerous diseases eg juvenile arthritis. This disease occurs only in children from 2 to 16 years old and, if left untreated, can progress very quickly, leading to disability.
- Pain not related to the limbs. little child He can easily start limping if he gets a severe stomach ache while walking. And if a few minutes ago he was vaccinated, for example, DPT, then the baby may temporarily limp due to pain in the buttock during the process of resorption of the vaccine. Quite often, such temporary and harmless lameness develops in children after Pentaxim, a combination vaccine.
- Neurological disorders. With damage to certain groups of nerves, as well as with damage to the central nervous system lameness may develop.
- Limb injuries. It is quite possible that during outdoor games the baby twisted or pulled his leg, bruised it or injured it. It is very difficult to recognize such injuries on your own. On initial stage they are practically invisible, except for the wound.
- Bony tumor processes . That's enough serious diagnoses, which develop gradually and require no less serious diagnostics in a hospital setting.
- Post-traumatic causes . If the child was forced to observe for some time bed rest If he wore a cast on his leg, then post-traumatic lameness may be observed for some time after the cast is removed.
Even if it seems that the child began to limp for no reason, this is not so. It’s just that not every reason can be found and solved right away.
For more information about the reasons for a child's lame gait, see the following video.
How can I help?
If the leg is not changed, there are no wounds, calluses, abrasions, splinters, then you should definitely show the child to an orthopedic doctor. If necessary, this doctor will prescribe an MRI, computed tomography, radiographic examination. To clarify the origin of the problem, do ultrasound examination articulations of joints.
In case of injuries or suspicion of them (parents will be informed about this by the presence of edema, large hematoma, color changes skin, unnatural position of the foot or knee in the joint) help should be provided immediately. The child should be urgently taken to the nearest emergency room and shown to a traumatologist. It is advisable to indicate under what circumstances the child began to limp- after a fall, while running, after a jump, etc. This will help to quickly determine the nature of the injury.
Causes that can be eliminated independently do not require medical consultation. These include calluses due to tight or uncomfortable shoes, hip pain after a vaccination or injection in the buttock.
These conditions will go away on their own; you just need to change your baby’s shoes or wait a few hours after vaccination.
Physiological reasons associated with intensive growth of limbs, are most common in children aged 7 to 14 years. A minor pain syndrome that appears suddenly, usually after sleep or long sitting, goes away within an hour or two. The problem does not need treatment. But if in doubt, you should show your child to an orthopedic surgeon.
First aid
If the child not only limps on the right or left leg, but also complains about severe pain, you need to limit the load by laying the baby down, immobilize the leg, apply cold in case of swelling and call an ambulance. There is no need to give medications while waiting for emergency doctors.
Treatment
Treatment for lameness will depend on the underlying cause. Despite the fact that most ailments of the musculoskeletal system are quite serious, many of them can be quite successfully treated by wearing orthopedic devices and devices, therapeutic exercises, physical exercise and massage. Drug treatment is not prescribed in all cases, as well as surgery. Therefore, there is no need to be dramatic and nervous. But under no circumstances should a “lame” gait be left without due attention.
Many diseases of bones and joints, which at the initial stage can be cured by massage and proper nutrition, V neglected form you will only have to operate, and even then without guarantees that the child will be able to return to normal gait after surgery.
How to stop a child from limping after a fracture?
If baby for a long time spent in a cast, after removing the fixing bandage he may immediately develop lameness. There is no need to worry; a change in gait after an injury, provided that everything has healed normally, is a temporary phenomenon. If the doctor has confirmed that the bones and joints are in order, you need to gradually increase the load on the leg.
It is very good to walk on sand; it will make it easier for the child to distribute the load on his legs. It's a good idea to start swimming. It is useful to play the ball with your foot, lightly kicking it towards mom and receiving the return serve. This “football” allows you to regain coordination and confident movements.
It is difficult for the baby to fully step on the leg, which until recently was very painful. banal fear of a possible recurrence of pain. Do him home massage, show that there is no more pain. The child needs to be given vitamin complexes and calcium supplements, explaining that these “magic” pills will help the leg become strong and strong as before. This element of psychotherapeutic influence on children with their characteristic wild imagination usually works flawlessly.
The load should be increased gradually, extending the time hiking just 2-3 minutes a day. The child should not be allowed to become very tired when walking; with fatigue, the lameness will intensify.
28.05.2009, 11:06
28.05.2009, 11:30
you urgently need a good orthopedist and at least thermal imaging - it’s better to be over-safe than under-dressed, and don’t forget that complete rest is complete rest, it is advisable to lie down, if the child needs to move somewhere, then it is better to carry him in your arms
28.05.2009, 11:38
We also had this and also assumed a deficiency minerals, weak muscle tone, but it turned out that I had cut my toenails poorly and one of them turned out to have a sharp edge - it dug into the next finger and my daughter was limping... Here. I trimmed my nails - the next day everything was OK!
Get well soon! :flower:
28.05.2009, 11:49
Moms, I'm fully loaded. The child suddenly began to limp on one leg, and three days later she was taken to a surgeon. He made a preliminary diagnosis of the essence of our problem, he explained to me - a lack of substances with active bone growth. He prescribed complete rest and three days of Nurofen. And then see an orthopedist if nothing changes. But I can’t imagine how we should do an x-ray - he wriggled and screamed obscenities at the reception. Maybe someone has had this happen - how long did the leg last?
We had everything the same and just at 3 years old (even 3.5). We went to a surgeon and an orthopedist (an orthopedist from the Turner Institute (if I’m writing correctly)). The orthopedist ordered an x-ray hip joint both standing and lying down and in all projections and ultrasound, I shortened the legs by 1 cm. When we came to take a picture at the hospital, the radiologist refused to take it for us, saying that such a “Chernobyl” (only 8 pictures) would not suit the child, or bring a detailed referral from the doctor. In short, I felt sorry for our cub. An ultrasound showed hip dysplasia. I don’t remember who (I think the surgeon) recommended a swimming pool and a bicycle. A month later everything was gone (before that I seemed to sometimes have a limp, but not always). But a year later, when we went for a second ultrasound, no abnormalities were found, the ultrasound specialist said that apparently there was a lack of calcium during the growth period (one thing after another could not keep up). We have not gone to this orthopedist again and will not go again. Now my son is almost 7 years old, nothing like this has ever happened again!
28.05.2009, 11:52
Moms, I'm fully loaded. The child suddenly began to limp on one leg, and three days later she was taken to a surgeon. He made a preliminary diagnosis of the essence of our problem, he explained to me - a lack of substances with active bone growth. He prescribed complete rest and three days of Nurofen. And then see an orthopedist if nothing changes. But I can’t imagine how we should do an x-ray - he wriggled and screamed obscenities at the reception. Maybe someone has had this happen - how long did the leg last?
Kookaburra
28.05.2009, 12:28
Moms, I'm fully loaded. The child suddenly began to limp on one leg, and three days later she was taken to a surgeon. He made a preliminary diagnosis of the essence of our problem, he explained to me - a lack of substances with active bone growth. He prescribed complete rest and three days of Nurofen. And then see an orthopedist if nothing changes. But I can’t imagine how we should do an x-ray - he wriggled and screamed obscenities at the reception. Maybe someone has had this happen - how long did the leg last?
There may be arthritis, consult an orthopedist and rheumatologist.
Get well soon :flower:
28.05.2009, 13:02
We had everything the same and just at 3 years old (even 3.5). We went to a surgeon and an orthopedist (an orthopedist from the Turner Institute (if I’m writing correctly)). The orthopedist prescribed x-rays of the hip joint both standing and lying down and in all projections and ultrasound, and shortened the leg by 1 cm. When we came to take a picture at the hospital, the radiologist refused to take it for us, saying that such a “Chernobyl” (only 8 pictures) would not suit the child, or bring a detailed referral from the doctor. In short, I felt sorry for our cub. An ultrasound showed hip dysplasia. I don’t remember who (I think the surgeon) recommended a swimming pool and a bicycle. A month later, everything disappeared (before that, I seemed to sometimes have a limp, but not always). But a year later, when we went for a second ultrasound, no abnormalities were found, the ultrasound specialist said that apparently there was a lack of calcium during the growth period (one thing after another could not keep up). We have not gone to this orthopedist again and will not go again. Now my son is almost 7 years old, nothing like this has ever happened again!
I'm not a doctor and I can't guarantee that it's the same for you, but the beginning is very similar. I hope everything goes well and everything goes well for you. Good luck!
Thank you. The surgeon also refused to do “Chernobyl” on the entire leg. Let's go for an ultrasound. Only my head is ready to beat - the second summer, because of misfortunes, money and paid vacations are lost - as a result, we are sitting at home with the child, where can we swim...
28.05.2009, 13:02
Similar symptoms occur with coxitis, so it’s better to run to an orthopedist. You haven’t had any vaccinations, haven’t you been sick recently?
Please explain what coxitis is... we haven’t had any vaccinations, we haven’t been sick...
28.05.2009, 13:04
Yesterday we were also asked by the orthopedist if the child was complaining of pain in the legs, even this surprised me, and judging by the topic this is not a joke. We were prescribed (we have nothing) but for prevention some vitamins with calcium
28.05.2009, 13:17
Thank you. The surgeon also refused to do “Chernobyl” on the entire leg. Let's go for an ultrasound. Only my head is ready to beat - the second summer, because of misfortunes, money and paid vacations are lost - as a result, we are sitting at home with the child, where can we swim...
And we went to the pool. But by the age of 4 he had already learned to swim. Double benefit! Hang in there, with children it’s not one thing, it’s another (we have now found bradycardia, we are being treated and waiting that maybe we too will “outgrow”).
28.05.2009, 14:47
Please explain what coxitis is... we haven’t had any vaccinations, we haven’t been sick...
After vaccination, the child had inflammation of the tissues of the hip joint. He was limping on one leg. This happens after past diseases etc. A blood test is taken and C-reactive protein is checked, i.e. rheumatoid factor.
28.05.2009, 15:23
It would not hurt to go to a rheumatologist if the surgeon does not find any pathology. In children, reactive arthritis and rheumatoid arthritis are possible. Let specialists figure it out, not on the forum.
28.05.2009, 15:27
Similar symptoms occur with coxitis, so it’s better to run to an orthopedist. You haven’t had any vaccinations, haven’t you been sick recently?
+1. It looks like coxitis. You didn’t happen to have a sore throat the day before, could it have been a complication?
*Pasta*
28.05.2009, 16:23
My nephew recently had this happen, they couldn’t make a diagnosis right away, then they came to the conclusion that due to a growth spurt (3 cm in a month), after 2 massage sessions he stopped limping, to date they have done 6 massages, the child goes to a nursery , runs, and up stairs too, no problem. I think a good massage therapist won’t ruin things...
Parents worry when they notice their child is limping. Usually the cause is trauma, but the child does not remember how or when it happened. A child may dislocate a leg in a joint or tear a tendon, but is often unable to connect the resulting lameness with specific situation. These "mechanical" causes are the most common, although there are many other causes of lameness.A child may limp if there is pain caused by tight shoes that squeeze the toes, abrasions, calluses, or blisters on the skin. In older children, lameness is often caused by an ingrown toenail. Therefore, it is important to examine the child’s feet, check whether the shoes are well-fitted, whether there are bruises, redness, splinters, swelling, and whether there is pain in the knees and hip joints when moving.
Sometimes inguinal hernias and enlarged inguinal lymph nodes can cause pain when walking when moving the leg forward and raising the knee.
Usually after a night's rest the pain goes away and the lameness disappears.
If the lameness persists in the following days, it means that the cause is not a splinter in the heel or a pebble in the shoe, but something else, about which you need to see a doctor.
Causes of lameness:
injury;
Perthes disease;
mental problems;
viral infections;
joint diseases;
bone diseases;
congenital dislocation of the hip joint.
Injury:
Trauma is the most common reason lameness. This applies, first of all, to young children. The discomfort appears the next day, when bruises and swelling are visible. During the game, the child does not immediately notice them.Perthes disease in children:
Perthes disease is a disease of the hip joint that usually occurs in children aged 2-10 years. Develops due to insufficient blood supply to the head femur, which leads to its deformation. Its course may vary. IN severe cases persistent lameness occurs, and later, if left untreated, inflammation of the joint and bone.Diagnosis requires x-ray examination of the hip and knee joints, especially if they feel pain. In the future, X-ray monitoring of treatment is indicated.
Mental problems:
Sometimes a child limps unusually, like an actor. If there is no swelling or changes in the skin, check joint movements. If the reason is unclear, talk to your child about problems at school or in the family. It is possible that in this way the child is trying to avoid school or participation in competitions. If lameness persists, a doctor's consultation and x-ray examination are necessary. Sometimes a child may limp so much after recovery (after a dislocation in a joint) in order to attract the attention of his parents.Viral infection:
Often causes increased body temperature and pain in the limb as a result of the introduction of the virus into the tissue. Sometimes “reactive” inflammation of the joints develops. Reactive arthritis can occur in the hip, knee, ankle and other joints.Sometimes this condition appears several weeks after the infection (runny nose, sore throat, cough). Bed rest is indicated and drug treatment as prescribed by a doctor.
Joint diseases (arthritis):
Joint diseases (arthritis) in children can occur due to various reasons. Fortunately, long-term, dysfunctional joint inflammation is rare. Infection of the skin when damaged can be complicated by bacteria entering the joints and causing their inflammation, while sore spot very sensitive. Rheumatic lesion joints is rare, although recent data indicate an increase in the incidence of rheumatism. Signs to look out for: pain, swelling, redness around the inflamed joint.Bone diseases:
The disease itself bone tissue causing lameness are rare. An example is inflammation of the bones (osteomyelitis), although this can be avoided and successfully treated with antibiotics.Another common ailment is Osgood-Schlatter disease, which manifests itself as pain in the knee at the site of attachment of the quadriceps tendon to the shin bone. The disease occurs in adolescence at the moment of greatest physical activity child. The inflammatory condition of the bone can be cured within a few months. Physiotherapy speeds up the healing process. Some blood disorders, such as leukemia, can cause bone pain in a child. It is rare. At the same time, other signs of the disease appear: anemia (anemia) and poor general health.
Sometimes bone cysts develop, which cause pain mainly at night and during physical activity.
Congenital dislocation of the hip joint:
Congenital dislocation of the hip joint causes persistent painless or mildly painful lameness. Appears during the period when the child begins to walk, between 8 and 15 months of life. This type of lameness is the result of congenital or very early acquired disorders. The causes may be: muscle atrophy, brain lesions, poliomyelitis, but, as a rule, congenital dislocation of the hip joint. Girls are more often affected than boys. Occurs with a frequency of 400 per 100,000 births. There is often a hereditary predisposition. Newborns and infants should be examined by an orthopedist in the maternity hospital and at the age of 2-3 months.If dislocations are suspected, an ultrasound of the hip joints or radiography is performed. If for some reason the dislocation was not detected and treatment began after 6 months of life, it cannot be said with confidence that the child will walk normally, even after surgery. In the case of early treatment, at the age of 1-4 months, the problem is solved quite successfully even without surgical treatment by the time the child begins to walk.
The most important thing is timely detection congenital dislocation in the hip joint. So, if a child is limping, first of all examine him, look for signs of injury: bruises, scratches, determine if there is soreness in the muscles and joints. Perhaps the cause was a pebble in the shoe or scuffs, tight, uncomfortable shoes. There may be swelling, bruising of the skin, skin infection or splinter. If there are no traces mechanical damage skin, check whether the inguinal and popliteal lymph nodes are enlarged, and whether movement in the joint causes pain.
For pain and fever, you can give paracetamol and wait a day. If the pain does not go away, you should consult a pediatrician or an orthopedist and traumatologist for advice and treatment. Thus, lameness in a child is most often caused by injury. A child who limps “for no reason” should be carefully examined, first of all, to determine whether there is a dislocation of the hip joint. If lameness persists for more than a day, a doctor's examination is necessary.
The child may begin to limp due to the development of deformities in the bones and joints. This pathology can be influenced, however, the cause of the deformation must first be carefully and thoroughly determined. Basically, progressive and persistent deformities are associated with microelementoses, or diseases initiated toxic effect substances that are found in the body in very small quantities. This can be determined by examining the child, and it is necessary to interview the parents in detail. In this case, positional treatment is possible; arch supports are used here, which are made according to individual casts; the material used to make the insole is also individual. Splints made from casts are also used, with the possibility of their correction. Elements of treatment such as massage and exercise therapy are also selected individually, the use of general scheme ineffective here. A rehabilitation doctor should provide advice on rehabilitation treatment.
The cause of lameness may be hip dysplasia, in which there may be abnormalities in the development of the hip joint, for example, incorrect orientation of the head and neck of the femur relative to the hip joint. acetabulum. In this case, the supporting function of the limb noticeably deteriorates.
Hip dysplasia is the result of improper development of the osteochondral base of the joint, the muscular and/or ligamentous-capsular apparatus of the joint, which occurs in the prenatal period.
This pathology affects girls much more often. It is mainly observed in children born in the breech position.
Additional delay factors normal development hip joint of the fetus are heredity, infections in the mother during pregnancy, high age of the parents, endocrine pathologies and toxicosis, which is most dangerous in the first half. The influence should not be discarded environmental factors, hazardous conditions when performing work, unbalanced diet pregnant woman, as well as deficiency of minerals and vitamins necessary for adequate formation connective tissue and mineralization of cartilage tissue.
There are three degrees of hip dysplasia.
Pre-dislocation is called underdevelopment of the hip joint when there is no displacement of the femoral head relative to the acetabulum.
With subluxation, there is a partial displacement of the femoral head relative to the acetabulum, and with dislocation, there is a complete displacement of the femoral head relative to the articular capsule.
These defects must be identified in time and treatment must be prescribed immediately, since the absence or deficiency therapeutic actions lead to transformation mild degree dysplasia into subluxation and further into dislocation.
Suspicions about the presence of such pathologies should arise if the child began to walk later than the recommended norm, he has a clearly pronounced arch in the lower back, and there is noticeable lameness in one leg. There are a number of other symptoms that are best dealt with by a doctor.
All of these can manifest themselves either simultaneously or partially. In this case, you should definitely consult a doctor who can diagnose “congenital dislocation of the hip” or “hip dysplasia” not only on the basis of visual symptoms, but also with the help of an x-ray examination.
Further treatment is carried out under the constant supervision of pediatric orthopedists and surgeons. Treatment is carried out by fixing the hip joints in a position favorable for the development and functioning of the hip joint. For this purpose, orthopedic devices such as Pavlik stirrups, Freik pillows, and spacer splints are used. Additionally prescribed exercises physical therapy and massage.
Timely diagnosis and correct treatment allow full restoration of functions. If this is not fully feasible, surgical treatment is prescribed.
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