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Acute paediatrics
Fractured fibula can mimic irritable hip
  1. T P Kinnaird,
  2. R C Beach
  1. Norfolk and Norwich University Hospital, Norwich, UK
  1. Correspondence to:
    Dr T P Kinnaird, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK;
    tim.kinnaird{at}btinternet.com

https://doi.org/10.1136/adc.88.2.167

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    A traumatic limp is a common presentation in childhood, particularly in the under 5s. While the commonest diagnosis is irritable hip ascribed to a transient synovitis, there is a long list of other and more sinister diagnoses.1–3 Clinical algorithms have been suggested to allow diagnosis and management, while avoiding the need for extensive investigation in most children.4 We present three cases where this approach missed the diagnosis of fractured fibula.

    CASE 1

    A 20 month old child was referred by his general practitioner with a five day history of left sided limp. He was able to weight bear and had had an upper respiratory tract infection during the previous week. There was no history of trauma. He had a low grade fever. He had full range of movement of his hips and there was no local tenderness. Full blood count and C reactive protein were normal. The erythrocyte sedimentation rate was 25. A provisional diagnosis of irritable …

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