Critical Diagnoses to Consider in the Assessment of Pediatric Patients Presenting with Limp in the Rheumatology Ward: A Cross-Sectional Study

Abstract

Objectives: Limping is a frequent reason for visits to emergency departments. The causes of limping in children are various, ranging from benign musculoskeletal problems to serious etiologies, such as malignancy and infections.

Methods: In this recent cross-sectional study, we evaluated the causes of limps in children referred to the pediatric rheumatology ward in northeast Iran. We collected clinical characteristics and demo-graphic data of patients with musculoskeletal limping and documented laboratory tests and other para-clinical findings. Statistical analysis was performed in SPSS software (version 23). A P-value < 0.05 was concluded to be statistically significant.

Results: Our study investigated 95 pediatric patients with limping referred to the rheumatology department, the majority of whom exhibited acute-onset limping (≤2 days). The most common reason for hospitalization in the rheumatology ward was transient synovitis (43.1%), followed by other causes of reactive arthritis (15.7%). Acute lymphocytic leukemia (ALL) accounted for limping in 6% of the patients, while benign and malignant bone tumors, including osteoid osteoma, osteosarcoma, and Ewing sarcoma, contributed to limping in 4.2% of cases.

Conclusion: While the cause of limping in children is mostly benign, it is crucial to recognize that the causes may not solely stem from musculoskeletal problems. In instances where the musculoskeletal sys-tem is involved, infections of the joints and bones should also be considered.

Keywords: Child; Limping; Musculoskeletal problems; Pediatric; Pediatric rheumatology ward.