4yo suddenly walking oddly and GP says wait and see

[YoungOnyx]

Hi all, first time posting so go easy please.

My 4 year old has started walking oddly over the last couple of weeks and I cant shake the feeling that something isnt right. He kind of lifts one leg higher and swings it round a bit, almost like a limp but not consistent. Some days its barely there and other days its really noticeable, especially when he is tired.

He has always been an active kid, climbing everything, running non stop, no issues meeting milestones. No recent big falls that I know of, no complaints of pain unless I really quiz him and then he just shrugs. No fever, no illness beforehand.

Took him to the GP last week and honestly felt completely brushed off. She watched him walk up and down the room once, said children go through funny phases with walking, probably a habit or tight muscles, and told me to give it a few weeks. No referral, no physio, nothing. I asked about hips because Ive googled (yes I know) and she said he would be in pain if it was anything like that.

But I am his mum and I see him every day and this is new. Nursery have mentioned it as well which is what finally pushed me to book the appointment in the first place. Im not usually an anxious parent and Im very aware of not wanting to be that mum, but I also dont want to ignore something important.

Am I being unreasonable to push back and ask for a second opinion or referral? Or do I actually need to calm down and wait it out like she said. Has anyone had similar where it was nothing or where it turned out to be something after being fobbed off?

Sorry this is long, just feeling a bit stupid and worried at the same time.

I would look up Perthes disease as mentioned above. I was diagnosed at age 7 with it ( and again at 11) and it was a limp that I had and no obvious pain. I had to walk on crutches for a year but that was almost 50 years ago and treatments are very different now.

Nope I’d get a second opinion 💙

Please go back to the GP. Before you go, send an email to the practice manager explaining your concerns and that you wish to be taken seriously. The care providers within the NHS have a responsibility to listen to concerns of close family members, especially mothers who are usually extremely intuitive about their children. The initiative named ‘Martha’s Rule’ is now an expectation of all gps and hospitals. They simply cannot fob you off.
By writing an email explicitly stating your concerns, the previous encounter and how you did not feel listened to, and your knowledge of Martha’s Rule it will leave a paper trail. A GP surgery will not want that on file as evidence they did not provide care. This should be enough to get listened to and a referral to the appropriate team underway.
I honestly wouldn’t leave it- it isn’t worth the risk of delaying care which might be vital but also as a mother you need reassurance, you will only continue to worry.

Don’t listen to them! My ds developed a limp at around 5 years old and used to cry for hours saying his leg hurt at night! We got told everything from “ he’s making it up to its growing pains”. Eventually i paid and took him private and he was immediately diagnosed with perthes disease in his hip which had already degraded very badly without treatment. The private consultant was absolutely disgusted at our treatment by the NHS. A mothers instinct is rarely wrong.

@YoungOnyx you're doing everything right, it is concerning.

Trust your instincts, always. It doesn't matter a jot what anyone else thinks.

If your Dr. has not reassured you, definitely go back (perhaps one of the other Drs. in the practice has more paediatric expertise ?)

Nurse here. There are so many things this could be, ranging from minor to major. Remember that minor things are common and are the most likely diagnosis. It may be that the Gp was trying to reassure you but came across in a very poor way, however a parents instinct should always be listened to. It’s better that a child is checked over a hundred times and everything be fine than miss the one time it matters.
Is your son able to do everything else normally? Has anything else changed, hand eye co-ordination, walking up stairs, can he lie down and raise each leg equally? If any of these or other things have also changed, take him back sooner than you planned to.
Just remember, you are your child’s voice and that should be listened to. Best of luck to you

It's sounds like the GP doesn't know and you're being fobbed off, they seem to be quite good at that. I would get a second opinion and if you can get a video of the funny walk to show the GP, that will likely help.

Absolutely trust your instincts.

go back and insist on a second opinion. If you really don’t trust your surgery try a walk in centre

This is very similar to what I noticed with my son when he was aged three and it was Perthes disease. He would need an x ray to diagnose this. Please read up on this and take him to local minor injuries department or children's hospital. Good luck

Just checking in on this one, does your daughter show any signs of ND?

You know your child and you know when something is “off” - plus the Nursery have noticed. Unfortunately, the NHS loves a bit of “watchful waiting” and are only reactive rather than proactive. Keep pushing, it’s the only way you will get the treatment you need. And I say that not only as the parent of a SEN child but also as someone who works in the NHS. Good luck and trust your mum instincts.

As well as the videos, ask the nursery to note down their observations and concerns for you to share with the GP. Ask them to note down how this compares to what they see in other children. E.g. they don't think there is another child they are copying, this isn't typical of something they see in kids this age. It will be harder for the GP to dismiss your concerns if people that deal with children this age for a living think it is unusual.

Second this! My nephew was diagnosed with Perthes after a spell of odd walking / limping. His evolved where he would have days when he would cry saying his leg hurt.

I’d go back now with the videos

Pain-free Perthes? Highly unlikely.

This has escalated my anxiety levels quite a bit if Im honest but also clarified what I need to do.

Ive tried asking him in different ways this evening, more about things feeling funny rather than hurting. He just sort of shrugged and said his leg feels tired sometimes which may mean nothing but also doesnt feel hugely reassuring.

He is otherwise completely himself. Running, climbing, fine with stairs, no changes in hands or balance that Ive noticed. If anything thats what makes the walk stand out because everything else seems so normal.

The Martha’s Rule comment is interesting, I wasnt aware of that and the idea of a paper trail actually makes sense. Im not looking to get anyone in trouble but I do want to be listened to and not sent away with another wait and see.

I will speak to nursery tomorrow and ask them to write down what theyve noticed and whether they think its unusual compared to other children. Between that and videos I feel like I can go back with something more solid.

Plan now is not to sit on this. I will give it until the end of this week and if its still there I will either go back to the GP and ask for a referral or go to a minor injuries unit if I feel Im not getting anywhere. I dont think I can just watch and wait much longer without feeling sick about it.

Im really hoping in a few weeks I can come back and say it was nothing and I overreacted, but right now my gut says keep pushing.

You have to be persistent with the medical profession. You'll probably get more joy (ironically) if the leg swing/foot drop starts to affect your DC in terms of falling and/or fatigue.

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.

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 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.

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'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.

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 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.

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.