Evaluation of acute gait abnormalities in preschool children.

The charts of 60 consecutive children aged less than 5 years hospitalized for evaluation of a new onset limp or refusal to bear weight were reviewed. Only 1 of 22 patients with a normal complete blood count (CBC), erythrocyte sedimentation rate (ESR), and temperature had an infection. Of the 14 patients with a diagnosis of infection, only one had a normal CBC, ESR, and temperature. Radiographs were diagnostic in only four cases, whereas aspiration identified nine of 13 infections. Thirty-five bone scans were performed; 18 led to a definitive diagnosis including synovitis osteomyelitis, Perthes disease, juvenile rheumatoid arthritis, (JRA), fracture, soft tissue infection, and discitis.