Neurology Book


Abnormal Gait in Children

Aka: Abnormal Gait in Children, Nonantalgic Gait in Children, Steppage Gait, Circumduction Gait, Equinus Gait, Gait Evaluation in Children, Pediatric Gait
  1. See Also
    1. Abnormal Gait
    2. Pediatric Limp
    3. Clubfoot
    4. In-Toeing
    5. Out-toeing
    6. Metatarsus Adductus
    7. Congenital Vertical Talus
    8. Calcaneovalgus Deformity
    9. Torsional Profile
    10. Foot Progression Angle
    11. Thigh-Foot Angle
    12. Hip Rotation Evaluation in Children
  2. Types: Antalgic Gait
    1. Stance phase on unaffected limb is shortened due to pain
    2. Refusal to bear weight (esp. with limited range of motion, systemic symptoms, fever) suggests Septic Arthritis
  3. Types: Non-Antalgic Gait
    1. Steppage Gait
      1. Cause: Neurologic deficit interferes with foot dorsiflexion
      2. Hip and Knee Joints are flexed excessively during swing phase (allows toes to clear ground)
    2. Trendelenburg Gait
      1. Cause: Developmental dysplasia of hip interferes with hip abduction
      2. Tests: Trandelenburg Test is positive
      3. Pelvis tilts downward toward the unaffected side during the swing phase
    3. Circumduction Gait
      1. Causes
        1. Limb-length discrepancy (Galeazzi Sign positive)
        2. Knee or ankle stiffness due to underlying neurologic or mechanical disorder
      2. Appearance
        1. Stance phase: Knee is hyperextended and locked
        2. Swing phase: Affected leg is abducted or circumducted
    4. Equinus Gait
      1. Causes
        1. Cerebral Palsy
        2. Achilles tendon tight
        3. Calcaneal Fracture
        4. Foot foreign body
        5. Limb-length discrepancy
      2. Appearance
        1. Toe Walking
  4. Exam: Foot Deformity
    1. Lateral view
      1. Normal neonatal foot dorsiflexed >90 degrees
      2. Rule-out fixed equinus (Clubfoot) position
        1. Tiptoe walking (foot plantar flexed)
        2. Tight heel cord
    2. Plantar view (footprint shape)
      1. Kidney bean (sole deviated medially)
        1. Metatarsus Adductus
      2. Banana (sole deviated laterally)
        1. Calcaneovalgus Deformity
    3. PA View (from behind, while in neutral position)
      1. Heel varus with inverted foot (medial malleoli apart)
        1. Metatarsus Adductus
      2. Heel valgus with everted foot (medial malleoli touch)
        1. Calcaneovalgus Deformity
  5. Exam: Rotational Deformity
    1. See Pediatric Limp
    2. Torsional Profile (Leg Rotation Evaluation in Children)
    3. Foot Progression Angle (In-Toeing, Out-toeing)
    4. Thigh-Foot Angle (tibial torsion)
    5. Hip Rotation Evaluation in Children (Femoral Anteversion)
  6. Exam: Angular Deformity
    1. Genu Varum (bow leg)
    2. Genu Valgum (knock knee)
  7. References
    1. Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]

O/E - steppage gait (C0437308)

Concepts Finding (T033)
SnomedCT 163689006, 140893005
Spanish al examen: marcha polineurítica (hallazgo), al examen: marcha polineurítica (categoría dependiente del contexto), al examen: marcha en estepage, al examen: marcha de gallo, al examen: marcha en estepaje, al examen: marcha polineurítica
English On examination - steppage gait, O/E - steppage gait (finding), O/E - steppage gait, On examination - steppage gait (context-dependent category), On examination - steppage gait (finding)
Derived from the NIH UMLS (Unified Medical Language System)

increased leg circumduction during swing phase of gait (C2048853)

Concepts Finding (T033)
English increased leg circumduction during swing phase of gait, increased leg circumduction during swing phase of gait (physical finding)
Derived from the NIH UMLS (Unified Medical Language System)

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