| Abnormal
Gait
Video's
of abnormal gait will be reviewed in class.
Toe
walking:
Most
are habitual.
Differential
diagnosis:
Cerebral
palsy; intellectual disability; clumsy child syndrome; autism; dystonia
muscularum deformans; delayed maturation of corticospinal tracts;
diastematomyelia; muscular dystrophy; peroneal muscular atrophy;
gastrocnemius/soleus muscle equinus; talipes equino varus; sensory
integration dysfunction
Limping:
Abnormal
gait pattern due to pain, weakness or deformity. Most common abnormal
gait pattern is a decreased duration of the stance phase on the
side that is affected (as weightbearing on that side is painful).
Can
be painless or painful:
1)
Painful:
a)
Trauma (eg fracture, sprain, etc of foot)
b)
Infection (eg septic arthritis, osteomyelitis)
c) Intra-abdominal mass (eg appendicitis)
d)
Inflammatory disease (eg rheumatic fever, juvenile chronic arthritis)
e) Osteochondroses (eg calcaneal apophysitis, Kohler’s disease)
g) Congenital (eg patellar dislocation, accessory navicular)
h) Other (eg hip synovitis, slipped capital femoral epiphysis)
2)
Painless:
Usually
from alterations in muscle tone, strength or joint function:
a)
Neurological causes (eg flaccid paralysis, spasticity (cerebral
palsy), ataxia, spinal diseases)
b)
Muscle diseases (eg muscular dystrophy)
c)
Joint diseases (eg contractures, hypermobility, developmental dysplasia
of the hip)
d)
Bone disorders/diseases (eg leg length discrepancies, coxa vara,
Blount’s disease)
e)
Hysterical
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