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

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.