A 12-year-old boy presents with a 4-day history of a limp associated with a fever. Notable findings on the physical examination are a temperature of 102°F (38.5°C), minimal weight bearing, and localized tenderness on palpation of the lateral right thigh and hip. There are no signs of abrasion or soft-tissue infection. The erythrocyte sedimentation rate and white blood cell count are significantly elevated.

Pediatric review literature helps to guide the clinician through approaches to patients who present with a limp. With each unique case, several questions likely arise. How should the physician address different presentations of a child who has the same primary complaint? What is the next step to consider in proceeding from a medical review that introduces a perspective to the problem? When should reviews or guidelines be followed? What is the disease probability for disorders that present with a limp? How should tests be conducted to determine...

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