Limping with no history of trauma

We see many children who have been brought to the Emergency Department because they have developed a limp (and/or pain) in the affected leg.

Most of these children will have an ‘irritable hip’ (see below) or another condition which does not need investigation to diagnose and will get better on its own without hospital treatment.

There are some other more serious causes of a limp, such as joint or bone infection which do need hospital treatment. The Emergency Department doctor will have considered these more serious causes by taking a history and examining your child carefully.

Irritable hip (or transient synovitis) is the most common cause of limp in childhood. It is due to inflammation (not infection) of the hip joint. The exact cause is not known but it often happens after a viral illness or an injury.

Your child may complain of pain in their hip, groin, thigh or knee and may have difficulty walking or crawling. Usually only one side is affected. It is generally a mild condition which gets better on its own after 1-2 weeks.

Please contact the Emergency Department immediately if your child:

• becomes unwell
• develops a high temperature
• has increasing pain, or
• is unable to put any weight at all on the affected leg.

These are symptoms that may indicate a more serious problem.
Otherwise, if there is no improvement after seven days, please see your GP.

You should encourage your child to rest the affected leg as much as possible over the next few days. This may mean that your child does not attend school or nursery until the clinic appointment.

Give regular pain relief medication, such as paracetamol and/or ibuprofen. Paracetamol can be given every 4-6 hours (no more than four times in 24 hours). Ibuprofen can be given every 6-8 hours (no more than three times in 24 hours). Do not exceed the prescribed dose. Most children will show some improvement over the next few days.

You can allow your child to gradually go back to their usual activities as they improve, but we advise against sport or strenuous activity for two weeks. Your child may still need pain-relief medication. Gradually reduce the number of times you give it in a day as they get better.

We would expect your child to be back to normal within 1 -2 weeks.

Please contact the Emergency Department if your child unexpectedly becomes worse in this time. Alternatively, if there is no improvement after seven days, please see your GP.

This leaflet gives general information only. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.