PEM Currents: The Pediatric Emergency Medicine Podcast
Brad Sobolewski, MD, MEd
149 episodes
2 days ago
PEM Currents: The Pediatric Emergency Medicine Podcast is an evidence-based podcast focused on the care of ill and injured children in the Emergency Department. The host is Brad Sobolewski, author of PEMBlog.com and a Professor of Pediatric Emergency Medicine at Cincinnati Children’s and the University of Cincinnati.
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PEM Currents: The Pediatric Emergency Medicine Podcast is an evidence-based podcast focused on the care of ill and injured children in the Emergency Department. The host is Brad Sobolewski, author of PEMBlog.com and a Professor of Pediatric Emergency Medicine at Cincinnati Children’s and the University of Cincinnati.
PEM Currents: The Pediatric Emergency Medicine Podcast
12 minutes
2 months ago
The Limping Child
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Limping is a common complaint in pediatric emergency care, but the differential is broad and the stakes are high. In this episode, we walk through a detailed, age-based approach to the evaluation of the limping child. You’ll learn how to integrate the Kocher criteria, when imaging and labs are truly necessary, and how to avoid being misled by small joint effusions on ultrasound. We also highlight critical mimics like appendicitis, testicular torsion, and malignancy—and remind you why watching a child walk is one of the most valuable parts of the exam. Whether it’s transient synovitis, septic arthritis, or something much more concerning, this episode gives you the tools to manage pediatric limps with confidence.<br />
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Learning Objectives<br />
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* Apply an age-based approach to the differential diagnosis of limping in children.<br />
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* Demonstrate diagnostic reasoning by integrating history, physical exam, imaging, and lab findings to prioritize urgent conditions like septic arthritis and SCFE.<br />
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* Appropriately select and interpret imaging and lab studies, including understanding the utility and limitations of ultrasound, MRI, and the Kocher criteria.<br />
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Connect with Brad Sobolewski<br />
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Mastodon: <a href="https://med-mastodon.com/@bradsobo">@bradsobo@med-mastodon.com</a><br />
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PEMBlog: <a href="https://www.pemblog.com/">PEMBlog.com</a><br />
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Blue Sky: <a href="https://bsky.app/profile/bradsobo.bsky.social">@bradsobo</a><br />
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X (Twitter): <a href="https://twitter.com/PEMTweets">@PEMTweets</a><br />
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Instagram: <a href="https://www.instagram.com/bradsobolewski/">Brad Sobolewski</a><br />
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References<br />
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* Kocher MS, Zurakowski D, Kasser JR. Differentiating between septic arthritis and transient synovitis of the hip in children: an evidence-based clinical prediction algorithm. J Bone Joint Surg Am. 1999;81(12):1662-70. doi:<a href="https://doi.org/10.2106/00004623-199912000-00002">10.2106/00004623-199912000-00002</a><br />
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* UpToDate. Evaluation of limp in children. Accessed September 2025.<br />
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* UpToDate. Differential diagnosis of limp in children. Accessed September 2025.<br />
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* StatPearls. Antalgic Gait in Children. NCBI Bookshelf. Accessed September 2025.<br />
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* Pediatric Emergency Care. “Approach to Pediatric Limp.” Pediatrics in Review. 2024.<br />
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Transcript<br />
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Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 5 AI<br />
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Welcome to PEM Currents, the Pediatric Emergency Medicine podcast. As always, I’m your host, Brad Sobolewski, and in this episode we’re gonna tackle the evaluation of a child presenting with limp. We’ll cover, age-based differential diagnosis. How to take a high yield history and do a detailed physical exam, imaging strategies, lab tests, and when to worry about systemic causes.<br />
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We’ll also talk about the Kocher criteria for se
PEM Currents: The Pediatric Emergency Medicine Podcast
PEM Currents: The Pediatric Emergency Medicine Podcast is an evidence-based podcast focused on the care of ill and injured children in the Emergency Department. The host is Brad Sobolewski, author of PEMBlog.com and a Professor of Pediatric Emergency Medicine at Cincinnati Children’s and the University of Cincinnati.
