Year: 2024
Type: article
Study design: Observational Study
Abstract: 09 10 2024 10.60147/0ee7e710 https://pap.es/articulo/14232/fallo-de-medro-no-siempre-acierta-pero-si-alerta <!-- ============== --> Profile of the limping child Perfil del paciente con claudicación de la marcha Verónica Gimeno-Hernández Álvaro García Marisol Camacho Introduction: lameness is a frequent reason for primary care and emergency department visits. Material and methods: observational, longitudinal, retrospective study in patients who presented with lameness to the emergency department of a tertiary care hospital between 2019-2022. Patients were included by systematic random sampling. The study variables were: age, sex, time from onset, associated symptoms, history of trauma, personal and family history, source of referral (provider vs self), examination findings, diagnostic tests and results, treatment, diagnosis in emergency department, final diagnosis, aetiological group and discharge destination. Results: 321 patients, 65.1% male, with a mean age of 5.5 ± 3.4 years. Sixty percent sought care within 24 hours of onset and 81.6% were self-referred. Diagnostic tests were ordered in 87.5% (X-rays in 55.7%). The most common aetiology was inflammatory (29%), chiefly on account of transient synovitis (24%). We found an association between provider referral and a higher priority in triage (p=0.03), the use of ultrasound (p=0.009) and referral to outpatient specialists (p=0.003). The mean age of patients with abnormal sonographic findings (5.65 years) was higher compared to patients with normal results (3.84 years). There were also mean differences in the ages of the different aetiological groups (p=0.000) and in the different diagnoses made in the emergency department (p=0.002). We found an association between the presence of previous symptoms and the aetiological group (p=0.000) and between the time elapsed from onset to the visit and the aetiological group (p=0.002), interconsultation with traumatology (p=0.000) and destination after discharge (p =0.000). Conclusions: most causes of lameness are banal, but a high index of suspicion should be maintained for less frequent alternative diagnosis that may have more serious repercussions, such as JIA.
DOI: 10.60147/194309a5
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: gold
OpenAlex ID: W4403006960