Limp

Template

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Red flags presentChoose any

Red flags absentChoose any

ExamChoose one

Likely causeChoose one

ImagingChoose any

LabsChoose any

PlanChoose any

ReferralChoose any

DispositionChoose one

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Counseling

Most limps after a minor injury or a viral illness improve within a few days to a week. Recommended supportive care with tylenol or motrin as needed, with an emphasis on activity as tolerated and watching how the child walks. Return precautions given including fever, refusing to walk, swelling or redness of a joint, night pain, a limp that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Limp
• No fever, refusal to bear weight, joint swelling, pinpoint bony tenderness, night pain, weight loss, or unexplained bruising
• Well appearing; hips, knees, and feet examined without focal findings
• Observe at home
• Follow up if still limping in 1 week

Most limps after a minor injury or a viral illness improve within a few days to a week. Recommended supportive care with tylenol or motrin as needed, with an emphasis on activity as tolerated and watching how the child walks. Return precautions given including fever, refusing to walk, swelling or redness of a joint, night pain, a limp that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Red flags present or absent (fever, refusal to bear weight, joint findings, night pain, weight loss, bruising)
Exam above and below
Likely cause (minor injury, transient synovitis, toddler's fracture)
X-ray, labs
ED for infection concern

Return precautions in the template

feverrefusing to walkswelling or redness of a jointnight paina limp that is not improving

Sources

Sport-Related Concussion in Children and Adolescents. Clinical Report. Pediatrics 2018;142(6):e20183074. (newest AAP concussion CR found; also Early Childhood…
Overuse Injuries, Overtraining, and Burnout in Young Athletes. Clinical Report. Pediatrics 2024;153(2):e2023065129. (replaces earlier report)
Early Childhood Concussion. State-of-the-art review. Pediatrics 2024;154(5):e2023065484 (not an AAP policy)

Few formal guidelines cover this topic, so the template also leans on expert opinion.