Patient question

My child is limping and says the knee hurts. What should I do?

Dr. Pablo GelberOrthopaedic Knee Surgeon

Quick answer

A limp is a sign that something is genuinely wrong, so it should be examined rather than watched for weeks. In children the problem is often in the knee, but hip conditions commonly cause pain felt only at the knee. Fever, a hot joint or refusal to stand needs same-day care, advises Dr. Pablo Gelber, knee surgeon at Aman Hospital in Doha.

Go to emergency care today if

Your child has a fever with a limp, or a hot, red or swollen joint
They refuse to put any weight on the leg
The limp followed a fall and the leg looks deformed or very painful
They seem unwell, drowsy or are not eating
A teenager suddenly cannot walk with pain in the knee, thigh or groin

Joint infection and some hip conditions in children are time-sensitive, and early treatment protects the joint.

Common causes of a limp with knee pain

Minor injury: a bruise, sprain or a bump the child may not remember
Irritable hip (transient synovitis): a short-lived inflammation of the hip, often after a cold, in younger children
Perthes disease: a problem with the blood supply to the top of the thigh bone, usually between about 4 and 10 years
Slipped upper femoral growth plate (SUFE): in growing teenagers, often felt only in the knee
Overuse problems around the growth plates, such as Osgood-Schlatter disease
Less often: infection of the bone or joint, inflammatory arthritis, a stress fracture or, rarely, a tumour

Because hip problems so often show up as knee pain, a careful doctor always examines the hip in a limping child.

What you can do while you arrange a visit

If your child is well, without fever, and the limp is mild, rest from sport, give a simple painkiller at the right dose for their weight and watch for 24 to 48 hours. Note when the limp is worst, whether it is getting better, and anything that happened before it started. A limp that lasts more than a few days, or keeps returning, should be checked even if it seems mild.

What happens at an assessment at Aman Hospital

Dr. Gelber watches your child walk, then examines the knee, hip, spine and the other leg. Depending on the findings, X-rays of the knee and often the hips are taken, and sometimes an ultrasound of the hip, blood tests or an MRI. Many limps turn out to be minor and settle with rest, but finding the few serious causes early is what matters.

Frequently asked questions

My child limps but does not complain of pain. Should I still worry?

A painless limp still deserves an examination, especially if it is new or persistent. Young children often cannot describe pain, and some hip conditions cause a limp before pain appears.

Can I take my child to a physiotherapist first?

Physiotherapy is useful once the cause is known. For a new limp, a medical examination comes first so that hip and joint problems are not missed.