4yo suddenly walking oddly and GP says wait and see

You’ve reminded me about my (now) teenager. When he was younger, about 5 to 8, he occasionally would walk funny and say he had a sore hip. Quite a lots of times, but it would never last long enough or seem serious to ever see a GP. Completely resolved and haven’t thought about it for years.

One thing you can do whilst waiting to see another professional (and I agree that a physio would be useful) is measure his legs. My son developed a weird gait at around age 4 and a physio picked up that one leg was longer than the other.

I would turn up at the hospital if it doesn’t improve. An early morning visit to children a&e. I am not a panicky person either.
Best of luck.

I would video as many instances as you can in a week and then go back for a second opinion. Document times, dates, symptoms and return with determination.

I walked ( limped) around on a broken ankle as a 4 year old. It hurt but not enough for anyone to believe there was anything wrong aside from a mild sprain, or take me for an xray. Get a second opinion or some xrays at the least.

Our local health visiting service has an advice line. Could be worth trying that if you have similar? You might be able to get a referral that way or at least some back-up for going back to the GP. All the best, OP - I hope you get to the bottom of it soon.

My daughter had something like this but in her shoulder. She started to hold her arm funny and when she ran, would keep it straight down rather than swinging it like the other one. It was post-streptoccocal reactive arthritis. Was quite serious and needed anti-biotics.

If you think something's wrong, then keep pushing.

Don't feel stupid. Women are often made to feel like they're overreacting. Please ask your gp to investigate cerebal palsy.

If you do go back in with it mainly be prepared to ask questions. I learnt "BRAIN" in antenatal classes which have helped me so many times. It's more designed for understanding why a medical intervention or treatment is recommended but you can use bits of it.

So if they want you to wait and see, ask this:

What are the benefits of (waiting)?
Are there any risks? What are they? (How common, how serious)
Are there any alternatives to waiting? What are they? (Repeat process for each)

The last two don't really work for a passive approach but can be used additionally if a professional is suggesting something you feel unsure about.

Do we need to do this immediately or can it wait, how long should we wait to decide?
What happens if we do nothing? (This is often the most illuminating question!)

With a "wait and see" approach I have learned to ask how long do we wait/what are you expecting to see, are there any concerning signs to look out for, and what would next steps be if it doesn't improve. This usually gets you a little more clarity, along the lines of PPs explaining that a muscle injury should self-resolve within 3 weeks. I think sometimes doctors forget that not everyone has medical training so they say wait and see, assuming you'll know what a reasonable timescale is to wait.

If your child had always walked this way the id not be concerned but the fact that this is a new thing….i wouldn’t let it go. Something has happened as why are they walking differently all of a sudden? This needs more investigation

Sorry you are dealing with this! Taking him to a private physio for an initial assessment will be far cheaper than a private paediatrician app. They can assess and if they note any red flags will write up a proper letter of concern and signpost you to A&E. I’m an ED nurse and a lot of patients get sent via physio! The letters are very detailed and to the point.

Hi OP, I'm also a physio (although not paeds). Did the GP assess - actually get him lying down and feel the movement in the hip and knee? That tells you alot. However if this was my child, and I had this instinct that something wasn't right, I would just bring to minor injuries. Because I would want an x-ray to rule out some of things mentioned in this thread. If anything does show up they can then refer you directly to orthopedics rather than waiting for a referral, which depending on your area could be quicky, but more likely will not be. Changes to walking in children without any known trauma is something that is very appropriate to attend minor injuries/a&e with.

My little boy developed a sudden limp when he was 2 or 3. He would swing his leg out to the side and look off balance, it didn’t cause him any obvious pain and would come and go. I video recorded it and took him to A&E - they x rayed him and ruled out anything serious. I was so worried it could
be an infection or neuro problem I didn’t want to mess about waiting. They were happy to see him and no-one thought I was wasting their time.
This is what it was however - https://www.rch.org.au/kidsinfo/fact_sheets/Transient_synovitis/
it went away as quickly as it came. Hope your little one is ok.

Has he recently had any kind of virus? There is a post-viral complication that can cause problems with walking in young children. I know this because DB had it when he was a similar age.

This. See if nursery or the health visitor can step in. Once you are in the system they seem to work quite well. If it were my son I'd be asking for his GP as she is the paediatric specialist.

I'd go back to the surgery, ask for the GP with the most paediatric experience and then ask them for a physio referral. Could be something simple as symptoms can be similar for many different things so try not to worry.

Go with your gut, OP, and I say that as somebody who is very against utilising our scant medical resources unless absolutely necessary.

I experienced something similar with my gait, and even as an articulate adult with a full vocabulary it was still difficult to get medical professionals to understand that something was wrong. Hopefully it will turn out to to something minor or easily corrected. Good luck with your pushing

My son was like this age 2. Developed an on and off limp. Used to almost hold his leg straight and swing it to walk too. Initially got fobbed off a lot then took him to a and e after a couple of useless GP appts. Kept being told transient synovitis but didn’t fit and limp kept coming back. Went back to an and e again and saw consultant and they admitted for scans and bloods -all clear. Limp still got worse, he’d be literally falling over so they scanned his brain too - all clear. Once scans were clear they lost all interest! Went private and he was diagnosed with joint hyper mobility syndrome. Had hydrotherapy and intensive physio which hugely improved things. He 10 now and still has to do physio but climbs and swims to keep joints strong and doesn’t limp anymore apart from when he has a growth spurt.

I dont want to scare you but my son developed a limp pretty much overnight. I was told by the GP 10 days later that he needs to go straight to A&E as it can indicate an infection in the hip. There was no infection but he had undiagnosed hip dysplasia and had to have major surgery to correct it. My advice is, if you think something isn't right, then trust your instincts.

I’m the first one to roll my eyes at the “should I go to A&E?” type threads.

However, OP, I think that you should take this seriously, as you clearly are. I would be too. I have a recently-turned 4 year old and I know that asking about pain etc is often a bit fruitless.

Could you maybe play games? Do squeezing tickles of his leg, apply a bit of sneaky pressure when you’re washing him in the bath? Just to see if he reacts.

I think the suggestions that if he’s not in pain, it’s good, are maybe misplaced. I’m sure you’ve googled and saw the worst case scenarios here, so I won’t say much more.

You’re the advocate here. Don’t take no for an answer. Videos etc are all great ideas for showing that you’re not neurotic, dramatic or exaggerating.

I'm a paediatric physio, we would accept this referral, including from a member of nursery staff, a health visitor etc. Every area is different, we don't accept self referral but we accept from any health or education professional

As others have said, take some videos when not aware being watched.

Any temperatures at all? My dc had a limp and a temp when a toddler and diagnosed with transient synovitis but the consultant made it very clear that if they had another incident of temp + limp to always always get it checked out and not be complacent because it could be leukaemia

I was like your little boy as a child - my parents were told by doctor's that I just had growing pains and at 4 I thought everyone could move their hip in and out of place at will.

I had a similar gait and my issue is a femur deformity rather than my hip.

As well as videoing him running and walking try to observe and photo how he sits and gets up from the floor - they are also good indicators and show that he has not just developed a limp for the fun of it.

If it does not sort itself out in a few weeks I would suggest you ask for a referral to a specialist orthopaedic hospital nearest to you rather than to your nearest hospital . It is just that some types of standard X-ray positions don't reveal the problem, depending on the reason for the limp.

You may be told at 4 that it is watch and wait but the first battle is to see the right person - if you go back to the GP for a referral most practices have a GP with an interest in MSK conditions.

I think some people on this thread could’ve chosen their words more carefully - no need to worry the poor OP stiff. Right now, your son has NOT been diagnosed with anything, so just focus on the plan you have and on getting him a referral. I’ve been that worried mum and it’s a horrible feeling, I’ve had hundreds of “instincts” that something was wrong with my child, but has it ever turned out to be the worst thing I worried about? No it hasn’t. Just a couple of months ago my 8 year old DD had a swollen ankle for a few months for no reason whatsoever as she hadn’t injured it, it kept going up and down and I was worried stiff about all sorts of nasty things and getting her X-rays and blood tests etc but it turned out to be nothing and it’s gone now. Anxiety takes over sometimes and our brain wants to tell us it’s going to be the worst possible scenario but there are so many other minor things it could be. You’re definitely doing the right thing in pushing for a referral sooner, but try not to panic. Keep us updated , sending you positive thoughts!!

I’d probably be happy to wait and see on this and then go back in a few weeks. Just to add to the possibilities, my daughter has one leg shorter than the other ( became more noticeable after growth spurt) and walks like this sometimes. Definitely worse at the start and end of the day.