My young child is limping. When should I worry?

Last reviewed: September 29, 2026

It depends on the signs. Worry when the limp comes with a fever, when the child will not stand or walk on the leg, or when the child seems ill. These can be signs of an infection in a joint or a bone. The child should be seen by a doctor the same day, because delayed treatment can damage the joint and the growing bone.

The most common cause is a short-lived swelling inside the hip joint that is not an infection (transient synovitis). Other causes include a bruise, a splinter or something stuck in the foot, and a small crack in the shinbone (toddler’s fracture).

A toddler’s fracture often does not show on the first X-ray. It heals well, with a short time in a cast or splint, or sometimes with no support at all.

If a limp does not get better, or comes with other signs that worry you, it could be something more serious. Talk to your child’s doctor.

In general:

• Get your child seen the same day for a limp with fever, refusal to stand or walk, or a child who seems ill.
• See your child’s doctor for a limp that does not get better.
• If the first X-ray is normal and the limp continues, ask whether it could still be a small fracture.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

• Kocher MS, et al. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. J Bone Joint Surg Am. 1999. https://doi.org/10.2106/00004623-199912000-00002
• Kocher MS, et al. Validation of a clinical prediction rule for the differentiation between septic arthritis and transient synovitis of the hip in children. J Bone Joint Surg Am. 2004. https://doi.org/10.2106/00004623-200408000-00005
• Caird MS, et al. Factors distinguishing septic arthritis from transient synovitis of the hip in children. J Bone Joint Surg Am. 2006. https://doi.org/10.2106/JBJS.E.00216
• Brown DW, Sheffer BW. Pediatric Septic Arthritis: An Update. Orthop Clin North Am. 2019. https://doi.org/10.1016/j.ocl.2019.05.003
• Naranje S, et al. A Systematic Approach to the Evaluation of a Limping Child. Am Fam Physician. 2015. https://pubmed.ncbi.nlm.nih.gov/26554284/
• Payares-Lizano M. The Limping Child. Pediatr Clin North Am. 2020. https://doi.org/10.1016/j.pcl.2019.09.009
• Herman MJ, Martinek M. The limping child. Pediatr Rev. 2015. https://doi.org/10.1542/pir.36-5-184
• Expert Panel on Pediatric Imaging. ACR Appropriateness Criteria: Acutely Limping Child Up To Age 5. J Am Coll Radiol. 2018. https://doi.org/10.1016/j.jacr.2018.09.030
• Wang Y, et al. The Toddler’s Fracture. Pediatr Emerg Care. 2022. https://doi.org/10.1097/PEC.0000000000002600

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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