Vol. 9, Issue 4, Part A (2025)

Limping in children is a frequent and often challenging presentation in orthopaedic outpatient clinics, encompassing a wide spectrum of conditions ranging from benign, self-limiting disorders to serious pathologies requiring urgent intervention. The clinical significance of a limp lies not only in identifying the underlying cause but also in determining the urgency of evaluation and management. Age-specific anatomy, developmental stages, and the child’s limited ability to localize pain add complexity to diagnosis. Common causes vary with age and include transient synovitis, developmental dysplasia of the hip, Perthes disease, slipped capital femoral epiphysis, infections, trauma, inflammatory disorders, and neoplasms. A structured outpatient approach emphasizing careful history, targeted physical examination, and judicious use of imaging and laboratory investigations is essential for timely diagnosis. Delayed or missed diagnoses may lead to long-term morbidity, growth disturbances, or life-threatening complications in selected cases. This review aims to provide an orthopaedic outpatient perspective on the common causes of limping in children, highlighting practical diagnostic considerations relevant to routine clinical practice. Emphasis is placed on differentiating painful from painless limp, acute from chronic onset, and traumatic from atraumatic etiologies. The role of red flag signs such as fever, night pain, refusal to bear weight, and systemic symptoms is discussed to aid early recognition of serious conditions. By synthesizing current evidence and clinical experience, this article seeks to assist clinicians in prioritizing differential diagnoses, optimizing investigation strategies, and improving decision-making in outpatient settings. A clear understanding of common etiologies and their presentations can enhance early intervention, reduce unnecessary investigations, and improve overall outcomes for children presenting with limping. The review also underscores the importance of parental reassurance, appropriate follow-up, and timely referral when uncertainty persists, ensuring that outpatient care remains both efficient and safe while addressing the unique diagnostic challenges inherent in paediatric musculoskeletal assessment. In everyday clinical practice.