Abstract
Background
Limping is a common presenting pediatric complaint, caused by conditions originating
in the lower extremities as well as in anatomical areas surrounding the hip joint.
Pathologic processes presenting with limping include trauma, inflammation, infection,
and malignancy.
Objectives
In this report, we present a case of pelvic abscess presenting with limping in a toddler.
We review common conditions presenting with limping in this age group, and discuss
laboratory and radiographic evaluation of limping in toddlers.
Case Report
A 20-month-old previously healthy boy presented for evaluation of limping and history
of fever. The physical examination was suggestive of transient synovitis. Radiological
evaluation revealed normal hip X-ray study, a normal complete blood count, and a moderately
increased erythrocyte sedimentation rate. Due to the persistence of limping, tenderness
over the inguinal area and subsequent development of edema over the inguinal area,
magnetic resonance images of the hip and pelvis were obtained, which revealed a pelvic
abscess. The patient improved after ultrasound-guided drainage of the abscess and
a course of intravenous antibiotics.
Conclusion
Although transient synovitis is the most common pathology that causes limping in toddlers,
limping can also be a presentation of pelvic pathology. Thus, in this age group, a
detailed physical examination of the patient with special emphasis on structures adjacent
to the hip joint is extremely important. Laboratory evaluation and additional imaging
help confirm the suspected diagnosis.
Keywords
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Article info
Publication history
Published online: October 14, 2010
Accepted:
May 19,
2010
Received in revised form:
February 23,
2010
Received:
August 7,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
