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Learn how to elucidate underlying cause of limp in child :

July 9, 2019

Editor's note:The 2019AAP National Conference & Exhibition will take place from Oct. 25-29 in New Orleans.

Joseph A. Bocchini Jr., M.D., FAAP, and Dale E. Jarka, M.D., FAAP, will present “Evaluation and Management of the Limping Child” (S3180) from 2-3:30 p.m. Sunday, Oct. 27 in room 352 of the convention center.

Dr. Bocchini is a member of the AAP Section on Infectious Diseases and professor of  pediatric infectious diseases in the Department of Pediatrics, Louisiana State University Health Sciences Center in Shreveport. Dr. Jarka is a member of the AAP Section on Orthopaedics and associate professor of orthopedic surgery at University of Missouri Kansas City School of Medicine. 

In the following Q&A, Dr. Bocchini summarizes what they plan to discuss and why pediatricians should attend the session.

Q: What are the key things you will be covering during the session?

A: We will discuss the following:

  • The differential diagnosis, which may include serious and potentially life- or limb-threatening conditions and includes a number of other disorders that affect the musculoskeletal and nervous systems.
  • A systematic approach that includes an appropriate history and physical exam, with imaging and/or laboratory studies as needed, which can provide the pediatrician with an accurate diagnosis.
  • Treatment protocols for various causes of a limp.

Q: Why is this an important topic for pediatricians?

A: A “limping” child is a frequent complaint. The etiology and urgency of the situation can be a challenge to elucidate; some conditions are clinically mild, whereas others deserve urgent — or even emergent — attention. We’ll work through a common sense algorithm for pediatricians to tackle this confusing problem.

Q: How did you get interested in this topic?

A: As a pediatric infectious diseases consultant, I am frequently called upon to aid in the development of a clinical and diagnostic evaluation when infection of a joint, bone or deep soft tissue is suspected and to aid in planning appropriate antibiotic selection and duration of therapy.

Q: What is the take-home message of the session?

A: A few well-orchestrated questions about history, carefully performed physical exam maneuvers, simple imaging studies and occasionally laboratory studies can be utilized to elucidate the underlying cause of most childhood “limps.”

Q: Is there anything else you would like to add?

A: We will demonstrate that a careful history and physical exam as well as ancillary studies, as needed, can usually identify the etiology of the limp, saving parents, caregivers and the health care system precious time and resources in unnecessary specialist consults and/or studies. I also will define the potential roles of consulting specialists.

For more coverage of the 2019 AAP National Conference & Exhibition, visit http://bit.ly/AAPNationalConference19.

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