The Limping Child in the Urgent Care Center

The Limping Child in the Urgent Care Center

Urgent message: The ability to evaluate children presenting with a limp—and to recognize red flags that help distinguish those to treat from those requiring immediate referral—should be within the purview of the urgent care clinician. Raymond W. Liu, MD, Hadeel Abaza, MD, and Allison Gilmore, MD A limping child without a clear traumatic history or diagnosis is a common presentation to an urgent care center. The broad differential diagnosis can be daunting, with causes that …

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Right Hip Pain on 3-year-old Girl

A 3-year-old girl presents to the urgent care center with right hip pain. She has no fever, and the parents report there was no trauma. The child has a limp and reproducible pain on external rotation of the right hip. White blood count is 11,900 with 40.7% lymphs. The erythrocyte sedimentation rate (ESR) is 3 mm/hour. The x-ray (Figure 1) shows fluid around the right hip joint; this finding was confirmed by ultrasound. View the …

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