Q) Dear Dr. Gwenn:
I hope you can help or give me some suggestions. My 2 1/2 year old son has started to limp within the last couple of days. He has no pain or fever. There has been no known injury or anything out of the normal. Any ideas what I should do? His limp is slight and he seems to be turning his right foot and walking on the outside of his foot.
Please point me in the right direction
Thank You SJ
Dear SJ:
This is a very common problem with toddlers and usually nothing to be overly concerned about.
Limp without trauma and pain is just as common as limp from a fall where toddlers are concerned. Many of the causes of limp are musculoskeletal even without a witnessed fall. When you think about the mechanics of walking, it's no wonder that toddlers trip, fall and stumble from time to time with legs that are not used to being upright and muscles that are learning new skills and gaining strength. It's amazing that more injuries don't occur when you think about it - due to being low to the ground and having pliable bones, toddlers are somewhat protected. It's an evolutionary "survival" trait of sorts.
Limp is technically an aberration or change in gait. Most causes of limp are musculoskeletal and often injury related, even when unwitnessed. A simple twisting of an ankle or bruise from falling could cause a toddler to limp. Suffice it to say, a limp that is not interfering with activities in an otherwise happy and well toddler is likely nothing to be alarmed about. That said, there are some signs to look for and alert your pediatrician about should any occur in a limping tot:
- Is the limp interfering with your toddler's usual activities?
- Is pain a feature?
- Is there fever?
- Has there been a known traumatic event - even if small, such as falling off a chair or tripping?
- Any physical signs, such as bruising or swelling or a rash?
- Has there been a change in your toddler's eating or mood?
Other than some sort of musculoskeletal issue, infections can cause limp in a variety of ways. Toddlers as a group are germ magnets, and they do get their fair share of colds and viruses. These illnesses can sometimes irritate the lining of joints causing discomfort when walking, which is a condition known as Toxic Synovitis-- pain and refusal to bear weight are almost always features of this . While true infectious arthritis can occur in children, there would be other obvious signs, such as swelling of the joints, pain and redness. These children also tend to be very irritable.
As a parent, it is certainly concerning to see your child limp, but if your child is otherwise fine and not slowed down by the limp, there is likely nothing major under foot . But should that change, call your doctor for advice and to arrange an appointment, especially if your child seems uncomfortable or develops fever, sick symptoms or swollen joints. Luckily, as with most situations out of the ordinary with our kids, watchful waiting and extra TLC is usually all that is needed - especially if your toddler is happily toddling!
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