Limping in a child can be caused by something as simple as a stone in the shoe, a blister on the foot, or a pulled muscle. But a limp can also be a sign of more serious trouble, such as a broken bone or an infection, so it should be investigated early to make sure no serious problems are present. Some children limp when they first learn how to walk. Among the causes of early limping are neurological damage (for example, cerebral palsy). Any limp at this age needs to be investigated as soon as possible, since the longer it goes untreated, the more difficult it may be to correct.

Conditions Associated with Limping

Once walking is well established, significant sudden limping usually indicates one of several conditions:

A "toddler" fracture
Hip injury or inflammation (synovitis)
Previously undiagnosed congenital hip dislocation
Infection in the bone or joint

Toddler fracture is a mild fracture that can occur with minor accidents, such as a slip on a newly waxed floor or a jump from a porch step or swing. Sometimes the child can explain how the injury occurred, but youngsters do so many things in one day that they may have difficulty recalling exactly what happened. Sometimes an older sibling or babysitter can solve the mystery.

Hip problems that cause a limp at this age usually are due to a viral joint infection and need to be brought to the attention of your physician. When a child has an infection in the bone or joint, there usually is fever, swelling of the joint and redness. If the infection is in the hip joint, the child will hold her leg flexed or bent at the hip and be extremely irritable and unwilling to move the hip and leg in any direction.

Sometimes a child is born with a dislocated hip that, in rare cases, goes undetected until the child starts to walk. As one leg is shorter than the other, the child will walk with an obvious limp, which will be persistent.

Treatment of Limps

If you know that your child's limp is due to a minor injury, such as a blister, cut, splinter in the foot or mild sprain, you can apply simple first-aid treatment at home. However, most other causes need to be examined and treated by a pediatrician. If your child has just started walking and is limping, the pediatrician should see her as soon as possible. Calls about limping in an older child may be delayed for 24 hours, since many of these problems disappear overnight.

X-rays of the hip or the entire leg may be necessary to make the diagnosis. This is most certainly true if there is a suspicion of a congenital dislocation of the hip. If an infection is present, antibiotics will be started immediately. (This will require hospitalization if the infection is in the joint or bone.) If a bone is broken or dislocated, it will be placed in a splint or cast, probably after consultation with a pediatric orthopedic specialist. If a congenital dislocated hip is diagnosed, referral to a pediatric orthopedist will be immediate, as proper treatment, including special casting and/or bracing, should not be delayed.