Leet A I, Skaggs D L
University of Southern California School of Medicine, Los Angeles, USA.
Am Fam Physician. 2000 Feb 15;61(4):1011-8.
A limp may be defined as any asymmetric deviation from a normal gait pattern. The differential diagnosis of a limp includes trauma, infection, neoplasia and inflammatory, congenital, neuromuscular or developmental disorders. Initially, a broad differential diagnosis should be considered to avoid overlooking less common conditions such as diskitis or psoas abscess. In any patient with a complaint of knee or thigh pain, an underlying hip condition should be considered. The patient's age can further narrow the differential diagnosis, because certain disease entities are age-specific. Vigilance is warranted in conditions requiring emergent treatment such as septic hip. The challenge to the family physician is to identify the cause of the limp and determine if further observation or immediate diagnostic work-up is indicated.
跛行可定义为与正常步态模式的任何不对称偏差。跛行的鉴别诊断包括创伤、感染、肿瘤以及炎症性、先天性、神经肌肉或发育性疾病。最初，应考虑广泛的鉴别诊断，以避免忽视不太常见的情况，如椎间盘炎或腰大肌脓肿。对于任何主诉膝关节或大腿疼痛的患者，都应考虑潜在的髋关节疾病。患者的年龄可进一步缩小鉴别诊断范围，因为某些疾病实体具有年龄特异性。对于诸如化脓性髋关节炎等需要紧急治疗的情况，必须保持警惕。家庭医生面临的挑战是确定跛行的原因，并确定是否需要进一步观察或立即进行诊断检查。
