Limping in children

If a child is limping, the limp is usually due to a minor injury such as a sprain or splinter.

Introduction

If a child is limping, the limp is usually due to a minor injury such as a sprain or splinter. But if there's no obvious cause, see your doctor as it may indicate a serious underlying medical condition.

Advice for parents

If your child has started limping, find out if they injured their leg or foot or trod on something sharp. Inspect the soles of their feet and in between their toes for a wound or blister. You may need to take your child to a minor injury unit, or if the injury is severe, to your nearest accident and emergency (A&E) department.

If there's no wound or sign of injury, your child may have an underlying medical condition that will need to be thoroughly investigated by your doctor, usually by arranging blood tests and an X-ray of your child's hip.

If your child also has a fever, take them to see your doctor as soon as possible. They will need to be urgently seen by a specialist to rule out a bone infection. If they seem unwell and won't put any weight on the leg, take them to A&E.

In the meantime, you can read on to learn about some of the likely medical causes of your child's limp. But it's important not to diagnose your child yourself – always leave that to your doctor.

Childhood medical conditions that cause a limp

The most common medical causes of an unexplained limp in a child are:

  • irritable hip
  • a severe viral infection
  • juvenile arthritis
  • the thigh bone slipping from the hip socket (slipped upper femoral epiphysis)

These, and some of the more unusual causes, are explained in more detail below.

Irritable hip

Irritable hip (also known as transient synovitis) is a common childhood condition that causes hip pain and limping. Children with irritible hip may also be reluctant to place weight on the affected hip joint, making it difficult for them to stand or walk.

The condition occurs when the lining that covers the hip joint becomes inflamed, although the cause of inflammation is unclear.

A diagnosis of irritable hip is only made after other more serious causes of a limp are ruled out (see below).

Read more about irritable hip.

Severe viral infection

Some viral infections can cause pain in the joints. If your child has a fever and pain in many joints as well as a limp, it is likely to be the cause. However, make sure you see your doctor for a proper diagnosis as they will want to rule out more serious bone infections like osteomyelitis and septic arthritis (see below).

Juvenile arthritis

Arthritis is often associated with older people, but sometimes it can also affect children. This is known as juvenile arthritis.

Arthritis causes pain and inflammation (swelling) of the joints and bones. A child with juvenile arthritis will feel stiff, especially first thing in the morning, and not be able to move their joints freely.

There's no cure for arthritis, but there are treatments that can slow down the condition's progress and help to control the symptoms.

Find out more about juvenile arthritis.

Thigh bone slipping from the hip socket

One of the most common hip disorders to affect adolescents is a slipped upper femoral epiphysis, where the thigh bone separates from the hip socket. This usually happens gradually over time, and tends to affect children older than 10 (especially overweight boys), although it can suddenly happen as the result of an injury.

If your child has a slipped upper femoral epiphysis, they should avoid walking or rotating the leg and will need to have surgery as soon as possible, to realign the bone and fix it into position.

Less common causes

Less common causes of a limp in a child are:

  • Perthes disease: typical in boys aged 5-10, this is loss of blood supply to the top of the thigh bone, causing the bone to grow abnormally
  • septic arthritis: usually affects children under 2, this is a bacterial infection of the hip, knee or ankle that severely restricts movement of the joint and needs treatment with surgery and antibiotics
  • scoliosis: abnormal curvature of the spine that can cause the child to lean to one side
  • developmental dysplasia of the hip: an abnormal or dislocated hip that occurred before birth or developed soon after birth
  • severe pain in the lower abdomen: for example caused by appendicitis
  • unequal leg lengths
  • a disease affecting the nerves: such as cerebral palsy
Content supplied by NHS Choices