Toddler age 3 limping 2 weeks

[BethMck]

Hello, sorry for the long post.

Just looking for a bit of advice please.. my ds is 3 in a week and started limping and complaining of pain in his right knee 2 weeks ago, he kept randomly saying ouch and then would refuse to walk or straighten his right leg, I took him to the gp after 4 days of him doing that and a random nose bleed that scared me.

Gp checked him over and said there was no sign of infection or illness etc, ds had no temperature and was walking fine and appeared to be in no pain when being examined, the gp said to take him to a&e to see the pediatrics for tests if he did it again at all, he continued doing it for the next few days, it would come and go and ds seemed absolutely fine other than refusing to walk on and off and saying his knee hurt, so I took him to a&e, the Dr there didn't seem bothered at all, said he is well so doesn't need an xray or blood test at that point and if he is still doing it in a week bring him back and they will run tests.

Fast forward a week and ds is still doing this on and off every day, it has become more often throughout the day, so from first doing it, going from doing it once or twice a day to now where he does it up to 5x in a day.. no other symptoms. I've heard of irritable hip and know this is the likely cause but surely the symptoms he has been having would be getting better rather than worse over the last week?

I am getting quite worried as I know painful limp in one leg can be something more serious! I'm going to take him back to get checked over on Monday and hopefully they will do an xray and blood test.

Has anybody else had their LO have Irritable hip that got worse after 2 weeks but then started to get better? How long did the pain and limping last for?

Anxiety is starting to creep in, I need some answers but when Dr's don't seem concerned it's frustrating 😔 thank you. X

Film him when he does it if you can. At least you can show the doctor if he doesn't present as limping.

I’d be pushing for a scan and bloods. It might not be serious but if it is, time is essential.

Fingers crossed it’s nothing.

Hi OP - we went through similar (though not as long) with our little boy. I insisted on x Ray, followed by referral on TWW to Paediatrics - first at our local hospital, then when they found something they didn't know quite what it was (after CT and MRI), to the Orthopaedic specialist (Agnes Hunt) hospital. The local DGH were pretty shit but specialist took it very seriously and have been great (if they have any suspicions, it will go to BHam as the specialist). It looks to be a non-ossyifying fibroma, his symptoms have gone away but he is still on follow up as they can't say for 100% (more like 99%, which isn't quite enough for me). It's apparently a frequent incidental finding - he had a temp at the same time and they think the irritable hip and pain was a symtom of an infection at the time. I would insist on xray, paediatric referral and blood tests. You know your child.

Thank you for your replies, I have never posted on here before, always been a silent reader and find the advice from everyone on here to be really helpful. As this is something that is really bothering me I was hoping somebody could reassure me and say they had similar and it turned out to be nothing. I have shown the gp pictures of how he holds his leg up and a video of him refusing to stand on it, but I will definitely show them at the hospital.

Kirbert2- the gp did say he would need xray and bloods if he carried on but hospital Dr's weren't concerned at all as he didn't have a temperature or raised lymph nodes, they said he presented as a perfectly well child and to give it 7 days and come back if it's still happening.. the fact its getting more frequent is worrying me and I will be pushing for tests at this point!

Blackforesthotchoc- how is your LO doing now? Has the pain and limping stopped? I hope they manage to give a proper diagnosis and get to the bottom of it soon! My LO is completely fine one minute and then the next he's saying ouch and stops in his tracks, gets on the floor and will refuse to put any weight on his right leg, he holds his leg bent at the knee and says his knee hurts, then 10,20,30 minutes later he's running around fine again, although the past couple of days he has started to walk very cautiously after refusing to weight bare and won't bend the knee, I'm just scared because it is definitely getting worse instead of better, been going on every day for the past 2 weeks! He still has no other symptoms though and looks completely fine otherwise!

He's okay now - occasionally pain, the worst thing is trying to differentiate between the reality he is a growing boy who's active in lots of different ways vs rational/irrational parental fears. He almost certainly has something that's an incidental finding which won't have an impact on his life.

In your circumstances, I genuinely would take him to different urgent care or a&e (try for paediatric a&e if you can), if you cant get gp or current hospital to take you seriously. Say your fear sarcoma or similar malignancy and that you want at least x Ray and bloods; I said in same situation "what's the risk if you're right, vs the risk if you're wrong" - from diagnostic perspective, xray and bloods at least very simple and no long term impact. There doesn't always have to be a temp or other symptoms.

I want to say that it's hugely unlikely to be that - childhood cancers are extremely rare, and sarcomas more so; it's so difficult to be rational in these situations though so I completely get where you are feeling right now. Ultimately - you're his mum; you know if something doesn't feel right so trust your instincts.

Absolutely, it's so hard isn't it, I'm the kind of person to notice little changes in my kids and monitor them when I'm worried, this is something I've never experienced with any of my 4 before, I'm hoping and praying it is just a random symptom that will go away and just be a bit of a mystery but each day that goes by I'm more nervous as its not getting better, and actually becoming more frequent. My cousins ds had sarcoma diagnosis a couple of years ago, he had a single bruise that wouldn't go away and it took the Dr's 4 months and her taking him multiple times before someone took her concerns seriously, he was only 4 at the time and she was told numerous times its probably nothing serious at his age! I wish they would rule out the scary stuff first! Her LO is absolutely fine and in remission now thank god. It's just how they say it's unlikely, of course its unlikely but it isn't impossible! My local hospital does have the pediatric department so I'm hoping when I take him again they will do something this time instead of dismissing him because he doesn't look poorly! Something is clearly not right. He says it hurts and it's the same spot he points to every time

I'd definitely be pushing for the x ray and bloods. A perfectly well child doesn't limp, especially after not hurting themselves.

My son has been in remission from non hodgkins lymphoma for 3 months now and of course, most of the time it isn't cancer but if it is then starting treatment as soon as possible is so important because the earlier it is caught, the better treatment options available.

When I was 3 or 4 I started walking on my tiptoes all the time and it freaked my mother out so she took me to the doctor.
The doctor asked me why I was walking on my tiptoes all the time and I told him, “because I want to.”
The doctor told my mother, “Because she wants to.” That was my diagnosis lol.
My mum was furious with me. Why me?
I think she should’ve calmed down.
Just a light note, @BethMck to maybe help you smile when you don’t have very much to smile about.
Sending positive thoughts and love ❤️

This is what is bothering me, if he is perfectly well and they are not concerned why is he limping and in pain, and not getting better!

I'm so happy to hear you LO is in remission and so sorry you went through that, I hope your LO continues to go from strength to strength!

I'm definitely taking my ds back and I'm sure after 2 weeks of a random limp they will want to investigate

Haha that is a funny tale!! Kids really do know how to embarrass us don't they! I remember last week sat in a&e and my son was charging about playing with the toys and I thought they are going to laugh me out of here because he was having a great time! They definitely wasn't concerned after looking at him and taking his obs, I'm hoping they will take things more seriously this time!
Thank you for the positive thoughts 😊 x

Thanks. It's definitely been an emotional rollercoaster, glad that this year is almost over.

Hope your little one is ok and it's nothing serious.

Have a look at this and go through what has been ruled out. I would be pushing for a senior revire if he's still limping pemplaybook.org/podcast/please-just-stop-limping/

I could think of nothing worse than seeing your child go through that, here's to a new year filled with happier memories to be made ❤

Thank you for this, the Dr we saw said it was "probably irritable hip" as he didn't present as unwell, he had no temp or raised lymph nodes and was playing happily, he said if it was infection he would be pretty poorly. He said he wouldn't need any tests at the moment but bring him back in after 7 days if he is still complaining of pain and limping/refusing to weight bear.. which he is, every day, on and off but definitely more frequent than last week! I think they will investigate this time around with it not getting any better

I would probably get them to do a blood test to check for things like arthritis. My dd developed JIA at around 8 but I have heard of children much younger developing it. Her started with knees swelling to the size of grapefruits which was startling on her skinny legs. Hope you find out what is causing it

It will have been 7 days since I last took him tomorrow, he told me to give him calpol and ibuprofen and come back in 7 days if symptoms hadn't gone away, so I'm going to take him in tomorrow and ask for blood test and xray, he has had no visible swelling or warmth/redness, although tonight he did have a red patch on the side of his knee, the size of a bruise, he said he banged it I didn't witness it but I'm hoping it is just from a little bump he had and not another symptom, just strange how it's on the same knee he gets the pain! Hoping to have some answers tomorrow and be reassured that it's nothing serious! There are so many things it could be and most are harmless so I'm trying to convince myself everything will be fine but we can't help but worry when it comes to our children can we! I hope your LO doesn't suffer too much bless her, such a young age to have arthritis, I always thought that was what we get as we age!

My son had Perthes and all the pain/discomfort was in his knee. I’d push for an x-Ray on his hips to rule this out.

This has been coming up when I have used Dr Google, I haven't looked much into it as I've been looking more into Irritable hip 'which the Dr's guessed it would probably be'

What were the symptoms? Did the pain come and go? And get worse rather than better? He's been this way for 2 weeks now which is worrying me as I thought it would have gone by itself by now! How is your LO now? I'm taking him in tomorrow and will push for an xray and blood test if xray is clear

I doubt it's anything serious, on balance of probability (as everyone has said)!

However, if I were you, I think I would pick a quiet / hopefully quiet time and go to A&E. My local paediatric A&E is much quieter in the mornings than afternoons and evenings. If you say he's in a lot of pain they'll do an x-ray on the spot and that will hopefully put your mind at rest or at least get him in the system for further tests.

In other words, I wouldn't outright lie, but I think if you could describe the pain as severe they would suddenly do much more.

This is what I'm planning to do tomorrow, my hospital has pediatric department so I'm hoping as they told me to go back if there was no improvement that they will want to investigate further.. the Dr guessed it would probably be irritable hip and to take him back in 7 days if it was still happening, it has happened every day since and is becoming more frequent, seems to bother him more too, he will rub his knee and say ouch and refuse to stand on it more times in a day than he was last week so I definitely think it is getting worse rather than better, I'm sure it will be something far less serious than I'm fearing but it's so easy to worry isn't it. Fingers crossed we will get some answers tomorrow

i think your gp had done the right thing in saying likely nothing but need paeds if continues.

Im not sure back to ED will get you the follow up that you need now it’s ongoing. We’d probably bleed your child but if that’s clear and maybe an X-ray then you’re going to be frustrated by ED who let’s face it on the bank holiday weekend between Xmas and new year will be under siege.

It might be better to contact your GP and say it’s ongoing - here I can ring the paeds ward, discuss with a consultant and make a time for you to come up to paeds assessment/hot clinic which means if those initial tests are normal then you have a follow up in place etc.

I think the initial looks well, time as a diagnostic tool has been right - 95% would be better in that time or more symptoms appear to guide the diagnosis etc. Next I think you probably need a paeds referrals rather than the ED dept.

Please don’t do the ‘severe pain’ lie that a previous poster says above. It will just mean that when your child is assessed and isn’t in severe pain; a) we don’t really trust a parents history of the illness which makes it x100 times harder to ascertain what’s going on and b) you come away frustrated because the true story hasn’t been investigated. I’d investigate a recurrent, non painful/intermittently sore limp very differently to a ‘severe enduring pain’ leg.

Also videos are great. I often have parents saying ‘ I feel a fool because they look so well’ - I often say they aren’t a performing seal, they will always look different/ act different here.

I love a video because it’s a natural view of the limp, try and get a barefoot one if possible with the whole leg in view. It’s so useful for narrowing down the cause.

There is such a wide range of causes: from the terrifying malignant/cancer causes right through to a poor fitting shoe that has hurt a foot and now your wee one doesn’t want to walk that way.
It’s a case of rule out the awful things and then work through the softer diagnoses.

Thank you for your reply, I totally agree with what you are saying. My gp was brilliant he did all checks he possibly could to check my LO over and he said he couldn't refer him as he hadn't presented a reason for referral, which I completely understand and agree with. With advice from the gp to go to a&e peads department for more tests if it continued, that's what we did and of course, with him not presenting as an ill child I agree with the watch and wait they advised, what is bothering me is that the symptoms have become more frequent, the Dr we saw did tell me to bring him back to a&e if symptoms persisted or became worse after 7 days, which they have, the pain is not severe in the sense its unbearable so I wouldn't intend on telling them that, but it does seem to be bothering him more than it was last week, which is what I will tell them. I was thinking would it be best to contact gp but then I don't want to be waiting such a long time for a referral, whereas if he was seen by peads at a&e they could do an xray and bloods first and then follow up if nothing is found there and then.. I would feel much more reassured if an xray and bloods came back normal and then had to wait for whatever happens next, rather than waiting now for things to be ruled out, if it came back it was something more serious I would feel so guilty! I get that it's unlikely but having 2 cousins with cancer being told that it's unlikely, 1 died a short time after diagnosis at age 22 and one finally in remission at age 4 after being turned away from gp's for so long before diagnosis. I want the bad stuff ruled out first and then go from there instead of the other way round. Infection and injury has been ruled out, now I'm worried as it's getting worse and not better 😕 I do have pictures of how he holds his leg when refusing to stand and videos barefoot of him refusing to use the leg also. Appreciate your reply, thank you

I'd be pushing for an x-ray. My friend's toddler limped for a week. He'd broken his leg!