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Psychogenic limp in a child: are we aware of it?

Tripathy, Sujit K.a; Mishra, Biswa R.b; Mishra, Sayalic; Mohapatra, Debadattac

Journal of Pediatric Orthopaedics B:
doi: 10.1097/BPB.0000000000000044
Lower Limb
Abstract

A 10-year-old child presented with a limp for 9 months. The child was keeping his right knee extended and foot in the equinus position. The child had been investigated by numerous laboratory investigations and imaging procedures during the initial 9 months, but no organic cause was found. Without any conclusive diagnosis, the child was being managed by physical therapy. During examination in our clinic, the variable contraction of the quadriceps muscle raised the possibility of a psychiatric disorder. A psychiatrist’s opinion was sought and the child was found to have dissociative motor disorder. His conflict was identified and treated by cognitive behavioral therapy. The child walked normally after 1 week. A psychogenic limp is often not suspected by the orthopedic surgeon in the evaluation of a limp. The involvement of a psychiatrist in this evaluation may be helpful to identify the condition easily and even at the first instance.

Author Information

Departments of aOrthopedics

bPsychiatry, AIIMS

cDepartment of Psychiatry, KIMS, Bhubaneswar, Odisha, India

Correspondence to Sujit K. Tripathy, MS, DNB, Dip SICOT, Department of Orthopedics, AIIMS, Bhubaneswar 751019, Odisha, India Tel: +91 674 247 6081; fax: +91 674 238 4603; e-mail: sujitortho@yahoo.co.in

© 2014 by Lippincott Williams & Wilkins, Inc.