Limp / Extremity pain

Bone tumor
Growing pains
Juvenile idiopathic arthritis
Legg Calve Perthes disease
Osgood Schlatter disease
Osteomyelitis
Post-infectious arthritis
Reactive arthritis
Rheumatic fever
Septic arthritis
Slipped capital femoral epiphysis
Transient synovitis
Trauma / injury

  • Identify the basic anatomy and physiology of the musculoskeletal system
  • Describe the growth and development of bones, joints, and surrounding soft tissues
  • Describe the components of normal gait
  • Explain the infectious and non-infectious causes of musculoskeletal pain and inflammation
  • Define innate and humoral immunity and describe the pathophysiology of autoimmune diseases
  • Summarize the process of repair and healing of musculoskeletal injury
  • Describe the basic principles of pharmacology used in the management of inflammation and pain

Overview & Foundational Knowledge

Tse SML & Laxer RM. Approach to Acute Limb Pain in Childhood. Pediatrics in Review 2006; 27: 170-180.

http://pedsinreview.aappublications.org/content/27/5/170

Case based discussion of non-inflammatory and inflammatory causes of acute limb pain. Essential read.

Huurman WW & Ginsburg GM. Musculoskeletal Injury in Children. Pediatrics in Review 1997; 18: 429.

http://pedsinreview.aappublications.org/content/18/12/429

Review of orthopedic injuries in children.

Junnila JL & Cartwright VW.  Chronic Musculoskeletal Pain in Children: Part I. Initial Evaluation. American Family Physician 2006; 74: 115-22.

http://www.aafp.org/afp/2006/0701/p115.html

Overview on the evaluation of musculoskeletal pain in children.

Junnila JL & Cartwright VW.  Chronic Musculoskeletal Pain in Children: Part II. Rheumatic Causes.  American Family Physician 2006; 74: 293-300.

http://www.aafp.org/afp/2006/0715/p293.html

Overview describing when to refer chronic musculoskeletal pain and inflammatory joint conditions.

John J & Chandran L. Arthritis in Children and Adolescents. Pediatrics in Review 2011; 32: 470.

http://pedsinreview.aappublications.org/content/32/11/470

Review of inflammatory causes of arthritis in children.

Virtual Patients or Cases

Gill P, MacPherson P, LeBlanc C, Ellsworth J PedCases- A Learning Module for Evaluation of a Pediatric Limp for Medical Students. MedEdPORTAL 2010.

https://www.mededportal.org/publication/7910

Audio podcast on the evaluation of the child with a limp. Includes nine cases on the pediatric patient with a limp. Available online through MedEdPORTAL.

University of Alberta Pedscases

Access through https://www.pedscases.com

Case based quiz on joint pain in a child.

University of Alberta Pedscases

Access through https://www.pedscases.com

Case based quiz on differential diagnosis of the child with a limp across different age groups.

Clinical Presentations