1 Could your child have had an injury?

2 Does your child have a swollen or painful knee or ankle?

3 Does your child have pain or discomfort in a hip or thigh without any obvious redness or swelling?

4 Has your child had a recent infection, such as a sore throat?

5 Is your child between 4 and 8 years old?

6 Is your child between 10 and 16 years old?

7 Does your child have a lump or tender swelling in the groin?

8 Call your doctor now

Possible cause and action In a small child, the only evidence of an injury may be a limp or reluctance to stand on the affected leg. Your doctor will examine your child to determine the diagnosis and may refer him or her for an X-ray or to hospital for tests and treatment.

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go to Joint and back problems

10 See your doctor within 24 hours

Possible cause Your child may have irritable hip, in which the lining of the joint becomes inflamed as a result of a recent infection elsewhere in the body.

Action Your doctor will examine your child and may arrange for an X-ray of the hip to make sure that the symptoms have no other cause. Most cases of irritable hip clear up with just a few days of rest in bed.

11 See your doctor within 24 hours

Possible cause Perthes' disease, in which the head of the femur becomes misshapen due to poor blood supply to the bone, is a possibility.

Action Your doctor will examine your child and may arrange for an X-ray of the hip to confirm the diagnosis. Bed rest will be necessary initially. In some cases, treatment with surgery may also be needed.

12 See your doctor within 24 hours

Possible cause Your child's symptoms may be due to a slipped femoral epiphysis. In this condition, the growing end of the femur (thighbone) at the hip partially "slips" or separates from the adjacent bone.

Action Your doctor will examine your child and may arrange for an X-ray to be taken. If the diagnosis is confirmed, your child will need surgery to secure the head of the femur in its correct position. He or she may also need surgery on the other leg to prevent the same problem from occurring.

13 See your doctor within 24 hours

Possible cause Swollen lymph nodes could be preventing your child from walking normally. The swelling may be due to an infection such as glandular fever or it may be a reaction to an injury in the leg or the foot.

Action The doctor will examine your child and may also arrange for blood tests to check for infection. If an injury has become infected, antibiotics may be needed.

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See your doctor within 24 hours if your child is limping and you cannot make a diagnosis from this chart.

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See your doctor within 24 hours if your child is limping and you cannot make a diagnosis from this chart.