Leighton Hospital, Crewe and Victoria Infirmary, Northwich Tel: Switchboard 01270 255141
Discharge advice for parents and carers of children
diagnosed with a limp
Why is my child limping?
We see many children who have been brought to the Emergency Department because they have developed a limp (and/or pain). Most of these children will have an irritable hip which does not require investigation and will get better on its own. Some other causes of a limp, that will get better on their own, are muscle sprain or a toddlers’ fracture.
There are other more serious causes of a limp, such as joint or bone infection which do need hospital treatment. The Emergency Department clinician will have ruled out these more serious causes by discussing your child’s medical history and performing a thorough examination of your child. Occasionally an X-ray may have been performed.
Toddlers’ fracture
This is a very small fracture of the tibia (one of the shin bones) that may be caused by a fall or twisting injury and is common in children under three. Often these fractures are not seen on x-ray and will not always be put into a cast. Treatment involves rest, if possible, and pain killers.
Transient Synovitis (Irritable Hip)
Transient synovitis is the most common cause of a limp in children. It is due to inflammation (not infection) of the hip joint. The exact cause of this is not known but it often happens after a viral illness or minor injury.
Your child may complain of pain in the hip / groin, thigh or knee and may have difficulty walking or crawling. Usually only one side is affected. It is a mild condition which gets better on its own within a couple of weeks.
What can I do to help my child at home?
Encourage your child to rest as much as possible over the next few days. This may mean they do not attend school or nursery until their next clinic appointment.
Give regular pain relief such as paracetamol and ibuprofen, not exceeding the recommended dose on the bottle / packet depending on their age.
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Does my child need to be seen again?
On discharge from the Emergency Department you will be given an appointment to attend the review clinic within the next three to five days to check if your child is improving. This is to follow up your child’s progress and ensure they are improving.
However, during this time between discharge and their appointment, please bring your child back to the Emergency Department to be seen sooner if your child:
becomes unwell develops a high temperature has increasing pain is unable to put weight on the affected leg
What will happen at the appointment?
This is a consultant led clinic so your child will be seen and reviewed by a senior doctor. This gives us a chance to check on their progress. We expect most children to be getting better by this point. If they are improving they will be discharged from the clinic.
If your child is unwell or not improving the doctor may decide to do further investigations to look for other causes of hip pain and a limp that may not have been apparent at the very beginning. These investigations may include X-rays and blood tests. We may refer your child to another team for further management.
When can I expect my child to recover fully?
Allow your child to gradually go back to their normal activities as they improve. However, we advise no sport or strenuous activities for two weeks or until the pain has gone. Gradually reduce the amount of painkillers over the next two weeks.
We expect your child to be back to normal in one to two weeks.
If this is not the case, then please either return to the Emergency Department or see your GP.
This information is available in audio, Braille, large print and other languages. To request a copy, please ask a member of staff.
Reviewed by Readers’ Panel July 2020
Printed August 2020 Review August 2022 Ref: EC/AE/0570820
NHS Choices www.nhs.uk
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