Assessing the limping child: A practical approach for urgent and primary care

The Limping Child 5 November 2025 12h00-13h00

Lecturer: Dr Charles Stewart, Paediatric A&E Consultant

A  practical update on assessing the limping child in primary care, urgent care and emergency settings. Dr Charles Stewart will walk through a rapid, structured approach—from triage and red flags to age-based differentials—and clarify when to investigate, when to reassure, and when to urgently refer. Real-world cases illustrate key decisions (e.g., septic arthritis vs transient synovitis, SUFE, Perthes’ disease, toddler’s fracture, overuse injuries).

Aims

• Equip clinicians with a safe, structured approach to the limping child.

Learning outcomes

1. Perform a succinct history and gait-focused exam tailored to the child’s age and acuity.

2. Recognise red flags for serious pathology (e.g., septic arthritis, malignancy, non-accidental injury, SUFE).

3. Differentiate common causes by age and presentation (transient synovitis, Perthes’, SUFE, DDH, osteomyelitis, fractures, overuse).

4. Select appropriate first-line investigations (when to avoid, when to order X-ray, US, labs).

5. Initiate safe initial management (analgesia, immobilisation, off-loading) and provide robust safety-netting.

Who should attend

GPs, ANPs/ENPs, paediatric nurses, pharmacists in general practice, physician associates, urgent care clinicians, paramedics, ED clinicians, and allied HCPs seeing children.

Timed agenda

• Rapid approach: history, examination, gait & hip assessment, red flags

• Age-based differentials: 0–4, 5–10, 11–16 (transient synovitis, Perthes’, SUFE, fractures, overuse)

• Investigations & imaging: when, what, and why; avoid over-testing

• Management & referral: analgesia, immobilisation, safety-netting, pathways

• Quick cases & Q&A

Faculty

Dr Charles Stewart is a Paediatric A&E Consultant with extensive experience Sports Injuries and  in acute paediatric presentations, teaching frontline clinicians pragmatic, evidence-based assessment and management.

Primary keywords:
limping child, paediatric limp, child hip pain, gait disturbance child, transient synovitis, Perthes disease, SUFE, septic arthritis child, paediatric red flags, urgent referral children

Secondary keywords (LSI):
toddler’s fracture, osteomyelitis child, DDH, non-accidental injury red flags, paediatric musculoskeletal assessment, hip ultrasound child, child won’t weight-bear