![]() Pandemics and violence against women and children. Peterman A, Potts A, O'Donnell M, et al.Sports- and recreation-related injury episodes in the United States, 2011–2014. Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis. Its incidence, epidemiology and relation to Perthes' disease. Acute non-traumatic hip pathology in children: incidence and presentation in family practice. Krul M, van der Wouden JC, Schellevis FG, et al. The limping child: epidemiology, assessment and outcome. Evaluating the child who presents with an acute limp. A complete blood count with differential, erythrocyte sedimentation rate, and C-reactive protein should be obtained if infection or malignancy is suspected. ![]() Abnormalities in bone marrow shown on magnetic resonance imaging indicate septic arthritis. Radiography shows the degenerative femoral head changes in Legg-Calvé-Perthes disease. Knee pain in an active adolescent may suggest Osgood-Schlatter disease. Hip pain in an adolescent who is overweight or has obesity may suggest slipped capital femoral epiphysis. Pain reported primarily at night can occur with neoplasms. Patient history, such as breech presentation at birth, and a leg-length discrepancy on physical examination may suggest developmental dysplasia of the hip. If septic arthritis is suspected, joint aspiration should be performed urgently with ultrasound guidance and the aspirated fluid sent for Gram staining, culture, and cell count. It can be differentiated from septic arthritis of the hip by the absence of fever or ill-appearance and with laboratory testing that shows normal or only mildly elevated inflammatory markers and white blood cell count. Transient synovitis of the hip is the cause of a limp in the absence of trauma in 80% to 85% of children. ![]() The differential diagnosis is broad and includes congenital/developmental, infectious, inflammatory, traumatic (including nonaccidental), and, less commonly, neoplastic etiologies. A limp is a deviation from normal gait pattern, with pain as the presenting feature in about 80% of cases. ![]()
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