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.

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

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.

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.

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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 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.

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.

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.

ED physician. Used to work in paediatrics. Kids do weird stuff like this all the time. Ask him every couple of hours is he in pain. Ask him why he's doing it. If no changes in a couple of weeks see a paediatrician.

@YoungOnyx

You should NOT wait it out. If something is wrong, better to find out now and get treatment started.

An MNer posted last year about her child having motor skills problems. If I remember correctly, the GP put her off, even after asking more than once to refer him. She took him to A&E because he was getting worse. It turned out he had a very large brain tumor. He was having very dangerous surgery and she'd checked in a couple of times throughout that day. Then she was supposed to see him in recovery, and that was the last post she made. It seemed likely there was a bad outcome.

I felt so bad for her- well, we all did. She tried so hard to get the GP to refer him for tests or to have him seen by pediatrics, couldn't get help, and there was something really wrong with him. If he'd been referred then instead of months of waiting, his chances would have been so much better.

I sincerely hope your little one wiil be okay.
Please, follow your gut instincts!

Trust your mum gut, if it feels like something is wrong then push for a referal. Its better to be wrong than miss something. I would also say to film him when he is walking, that way you can show the doctor if he doesn't do it in front of them.

A sudden change in gait, particularly 1 sided is cause for concern as a neurological symptom. Honestly after this timeframe I'd be at a and e. I work in healthcare and I've seen this sort of gait change turn out to be things like brain tumours. I've also seen it then out to be an irritable hip from viral infections. I wouldn't be assuming it's nothing while there is a serious and time sensitive differential

I’m so glad where I live anything I raise re my child is taken seriously, referrals are done immediately as well as detailed investigation. Is done.
take a video and go back to the gp.

Yes, one of mine walked on tip toes for a short time. It was just a stage.
Get it checked out and trust your instincts, but be assured most of these problems heal themselves or are a solvable physical issue so don't panic.

I would pay to see a private physio or chiro that way they can see if its anything muscular, get xrays done if needed etc google ones in your area and you can be seen quickly, I have taken my child to both before with great results

A limp in a young child is unusually due to pain, weakness or deformity. There are many underlying causes for these and require proper assessment to establish, not an opinion. You need to contact the GP and say you want a referral to paediatric physiotherapy. He needs a proper assessment to rule out conditions such as Perthes disease or hip dysplasia. If they have any concerns, they will refer for x-rays and/or to paediatric orthopaedics.

There are many changes in the lower limb structure and alignment as children grow. A sudden limp in a young child ALWAYS needs full assessment by paediatric physio or similar. There is a reasonable chance it’s not serious so don’t panic. However, this is NOT a wait and see situation. You can say you have been given this advice directly from an MSK (musculoskeletal) specialist.
Please keep up updated! I hope everything turns out ok.