Fallo de medro: no siempre acierta, pero sí alerta
Authors: de Hoyos M.ª Cristina , León José Pelayo , Puente Nuria , Recio Aránzazu , Barasoain Alberto , Bezanilla Carolina , Botija Gonzalo , Martínez Manuela , Bueno M.ª Mercedes 
Published: October 2024

</jats:p> </jats:abstract> <publication_date media_type='online'> <month>09</month> <day>10</day> <year>2024</year> </publication_date> <doi_data> <doi>10.60147/0ee7e710</doi> <resource>https://pap.es/articulo/14232/fallo-de-medro-no-siempre-acierta-pero-si-alerta</resource> </doi_data> </journal_article> <!-- ============== --><journal_article publication_type='full_text'> <titles><title>Profile of the limping child </title><original_language_title>Perfil del paciente con claudicación de la marcha </original_language_title> </titles> <contributors> <person_name sequence='first' contributor_role='author'> <given_name>Verónica</given_name> <surname>Gimeno-Hernández </surname> </person_name><person_name sequence='additional' contributor_role='author'> <given_name>Álvaro </given_name> <surname>García</surname> </person_name><person_name sequence='additional' contributor_role='author'> <given_name>Marisol </given_name> <surname>Camacho</surname> </person_name></contributors> <jats:abstract xml:lang='en'> <jats:p>Introduction: lameness is a frequent reason for primary care and emergency department visits. Material and methods: observational, longitudinal, retrospective study in patients who presented with lameness to the emergency department of a tertiary care hospital between 2019-2022. Patients were included by systematic random sampling. The study variables were: age, sex, time from onset, associated symptoms, history of trauma, personal and family history, source of referral (provider vs self), examination findings, diagnostic tests and results, treatment, diagnosis in emergency department, final diagnosis, aetiological group and discharge destination. Results: 321 patients, 65.1% male, with a mean age of 5.5 ± 3.4 years. Sixty percent sought care within 24 hours of onset and 81.6% were self-referred. Diagnostic tests were ordered in 87.5% (X-rays in 55.7%). The most common aetiology was inflammatory (29%), chiefly on account of transient synovitis (24%). We found an association between provider referral and a higher priority in triage (p=0.03), the use of ultrasound (p=0.009) and referral to outpatient specialists (p=0.003). The mean age of patients with abnormal sonographic findings (5.65 years) was higher compared to patients with normal results (3.84 years). There were also mean differences in the ages of the different aetiological groups (p=0.000) and in the different diagnoses made in the emergency department (p=0.002). We found an association between the presence of previous symptoms and the aetiological group (p=0.000) and between the time elapsed from onset to the visit and the aetiological group (p=0.002), interconsultation with traumatology (p=0.000) and destination after discharge (p =0.000). Conclusions: most causes of lameness are banal, but a high index of suspicion should be maintained for less frequent alternative diagnosis that may have more serious repercussions, such as JIA.