The limping child — when to worry and when to refer: a GP’s guide

INTRODUCTION

A paper by the King’s Fund in 2010 identified that GPs were more likely to refer younger children than older children with equivalent needs, suggesting lower confidence levels and lower thresholds for referrals.¹ An estimated 30% of GP consultations are musculoskeletal² and a quarter of all patients who visit their GP each year are aged <18 years.³ It is, therefore, important that GPs have a comprehensive understanding of common paediatric orthopaedic pathologies.

A limp is a common reason for a child to present to the GP. It is also one of the commonest referrals to the on-call orthopaedic team, due to the long list of differential diagnoses, some of which require urgent treatment.

This article outlines an approach to assessing a child with a painful limp and indications for referral to specialist services.