Paediatric Orthopaedics Post Reply

[Southfieldsmummy]

Hi

My 3.5yr old has started hobbling around. I am very concerned! GP doesn't know what is causing it. Can anyone recommend an orthopaedic consultant that specialises in paediatrics and is brilliant!

Thanks!

[AnuSatpute]

Hello, my daughter had the same issue a year ago and GPs had multiple diagnosis everything from birth defect to irritable hip syndrome ! After multiple visits to A&E, it turned out to be a severe oestiomyleitis ! Ms. Karen Daly at St.George's is very good and worth a consultation. I am very sorry if I have scared you and hope your little one feels better very soon.

[lorrwa]

http://www.parkside-hospital.co.uk/serv ... hopaedics/

Friend of mine's son broke his wrist playing football, were having to wait 3 weeks for St Georges fracture clinic apt, but seen very quickly and professionally at Parkside, through private medical insurance. You could ask your GP for referral if you have medical insurance, or don't mind paying.

[FLH03]

Hi, maybe you need to see a different GP if there is another at your practice, for a second opinion, it seems a bit odd to refer you straight to orthapaedics without having done some more investigations - like X-rays of the leg and hip as this shows up all sorts of skeletal, muscular and ligament issues, or it doesn't show anything and so may dismiss other areas. Maybe you have already been down this route, in which case sorry to state the obvious.

My (then 3 year old) boy was limping badly, falling over and tripping the whole time, not running properly, but was in no pain, the GP (Thurleigh Road practice) looked at his legs comparing length and movements and referred him for an X-ray which diagnosed Perthes Disease, and then we were referred to an excellent paediatric orthopaedic consultant called Alison Hulme who works out of Chelsea and Westminster, and we could see her on the NHS or privately. She is and has been brilliant.

Hope it all works out and you find out what is causing this soon, as I know its very worrying.

[Southfieldsmummy]

Thanks all!

He has had an x-ray which showed nothing. He has been diagnosed with joint laxity and given orthotic which we have now had for two weeks.

But it is over the last couple of weeks the limping has become pronounced and defo isn't just a case of flat feet! I dont think it is just the orthotics causing it as there was a time before Christmas when he was hobbliong but I just put it down to over-exertion.

Thankfully we have private healthcare through work so I just want to make sure that we are seeing the best orthopaedic paediatric person we can find!

[Mum2Alex]

Hi there
I'm a paediatrician. You need to be referred to one. ASAP.
Accept nothing less.
Not an orthopaedic consultant in the first instance - the paediatricians would jointly manage something like osteomyelitis anyway, but there is a bewildering array of possible diagnoses and the friendly paed is the person to see. But you should see one within the next 2 weeks.
Hope that helps
Charlie

[NoseyNoo]

Yes, definitely go back. My son was limping for 10 months and our concerns were ignored until we finally got the Perthes diagnosis. I'm not saying that your son has that but more that sometimes you really have to push to be heard. It's not 'right' that your son is hobbling around.

[Bwith3]

Great advice I think to see a paediatrician as they will look very much at the overall picture.

But if you do go on to needing a Paediatric Orthopaedic Surgeon I can definitely recommend a fabulous one. Fabian Norman-Taylor has his NHS practice at The London Evelina Children's Hospital just down the road at St Thomas' where he is Head of Children's Orthopaedics, and his private practice at The Portland Hospital. He is local too with his kids at one of the local primary schools. We really liked him and the way he dealt with the children and us as anxious parents.

The whole of the Evelina is amazing actually. Bit biased as I used to work there but my kids have also been treated there. It is so local and a dedicated children's hospital that it really should be everyone with kids' first port of call. It gets completely overshadowed by Great Ormond Street but who wants to cross the river if they don't have to? Keep it in mind.

Good luck with whichever route you decide to take.

[mummySW18]

I can highly recommend Neel Mohan who is a paediatric orthopaedic consultant. We saw him at Parkside hospital, but I believe he works out of st George's too. We saw him because my daughter walked strangely and he was v good and reassuring.

[Southfieldsmummy]

Thanks all.

Okay so who can recommend an excellent paediatrician please.

[Mum2Alex]

To be honest, if I were your GP and your son had an unexplained new limp without trauma i would refer you that day to the local hospital. Private medicine is not terribly useful in paediatrics. There are no private children's hospitals and you shouldn't spend time trying to find a world expert until you know what you are dealing with.

I don't wish to alarm you as it most probably is nothing to worry about but your son should be seen ASAP to make sure that is the case.

Kind regards
Charlie

[balhamite]

Someone above recommended Karen daly from st George's. Just want to add she also does private work out of parkside and was good with our baby.

You could also try speaking to Hilary rattue, she heads the paediatric physio team at st George's and does private home visits. She is very experienced and seems a very sensible person who really cares about her patients and might be a good sounding board to recommend who to see etc. you can google her and her contact details will come up.

Good luck and try not to worry x

[Southfieldsmummy]

We are off to see karen daly this week (thanks for the heads up on her parkside)

Charlie - you are alarming me! I am chasing my GP for a referral but he clearly doesn't feel it is urgent so given the NHS isn't referring me to a paediatrician the same day I will use my insurance to make sure we see one asap. As it is your field of expertise a recommendation would be much appreciated!

Thanks!

[Mum2Alex]

Sorry to alarm you. New onset limp without trauma in children is VERY rarely due to blood disorders. If there are other symptoms of this such as easy bruising or being very pale or lethargic please go to a hospital and get seen. No referral required - just pitch up in A&E.

Orthopaedic surgeons should be involved if it truly seems to be a joint/bone problem. This would be the case if you can see any asymmetry with the other leg, any lumps or bumps etc. Even then it may be better sorted by a paediatric rheumatologist so again my advice would be to seek a paediatric referral first.

I'm a subspecialist so don't have any great recommendations for general paediatricians in London but Peter Sebire who works out in the Windsor/Eton area is excellent and very sensible. To be honest, paediatric referrals are usually super quick and this is bread and butter stuff so I would urge you strongly not to delay to go privately. It is simply not true that if you pay for care it is better.

Kind regards and apologies for the alarm.
Charlie