TY - JOUR T1 - Paediatric acute non-traumatic limp presenting to the emergency department: a retrospective observational study JF - Emergency Medicine Journal JO - Emerg Med J DO - 10.1136/emermed-2022-212624 SP - emermed-2022-212624 AU - Jacky Tu AU - Mitchell Haines AU - Peter Gowdie AU - Simon Craig Y1 - 2022/11/22 UR - http://emj.bmj.com/content/early/2022/11/22/emermed-2022-212624.abstract N2 - Background Acute non-traumatic limp in children has many causes, ranging from common benign and self-limiting disease to serious time-sensitive emergencies such as septic arthritis. We aimed to (1) describe the epidemiology and workup of paediatric acute non-traumatic limp presentation in three Australian EDs and (2) compare investigations and treatment between a tertiary paediatric centre and two non-tertiary centres.Methods A retrospective chart review of children aged 0–16 years, with an initial presentation of non-traumatic limp to three EDs in Melbourne, Australia. Data on presentation, management and outcomes was systematically collected on all eligible patients.Results Of 63 941 presentations over a 12-month period, 475 (0.7%) met inclusion criteria. The median (IQR) age of presentation was 5 (3–8) years, with a male predominance (61%). Blood tests and imaging were performed in 39% and 51%, respectively. 34% of presentations had no investigations. The most frequent ED diagnoses were transient synovitis (37%) and viral myositis (16%). 84% were discharged home after ED evaluation. Compared with the two non-tertiary hospitals, children who presented to the tertiary centre were less likely to have any investigation performed (OR=0.41, 95% CI: 0.27 to 0.62, p<0.001) and more likely to be discharged home after evaluation (OR=4.67, 95% CI: 2.79 to 7.81, p<0.001).Conclusion Although mostly due to benign disorders, an important number of limping children who presented to the ED had serious disease, with approximately one-third of these not diagnosed at the initial ED visit. There is large variation in workup including blood test, imaging and decisions regarding ED disposition.Data are available upon reasonable request. ER -