The diagnostic approach involves ruling out potentially serious causes via the use of X-rays, blood tests, and sometimes joint aspiration.
When due to pain it is referred to as an antalgic gait, in which the foot is in contact with the ground for a shorter duration than usual; in severe cases there may be a refusal to walk.
[3] Other important causes are infectious arthritis, osteomyelitis, and slipped capital femoral epiphysis in children.
[9] Accidental or deliberate physical trauma may result in either a fracture, muscle bruising, or a contusion.
[9] A non-painful limp may be due to a number of mechanical conditions including hip dysplasia and leg length differences.
[2] Juvenile rheumatoid arthritis presents gradually with early morning stiffness, fatigue, and weight loss.
[7] Legg–Calvé–Perthes syndrome is a degenerative disease of the head of the femur which results in bone loss and deformity.
[9] Cancers including acute lymphocytic leukemia, osteosarcoma, and Ewing’s sarcoma may result in a gradual onset of limping in children.
[7][9] The diagnosis of the cause of a limp is often made based on history, physical exam findings, laboratory tests, and radiological examination.