The Limping Child

A limp is a common presentation to pediatricians, emergency centers, and orthopedists. A directed history and physical examination, and the development of a differential diagnosis based on limp type, patient's age, and the anatomic site that is most likely affected, provides a selective approach to diagnostic testing. Laboratory tests are indicated when infection, inflammatory arthritis, or a malignancy is considered. Imaging usually begins with plain radiography. Ultrasonography is valuable in assessing irritable hips. Advanced imaging is done in select cases. Prompt referral to an orthopedist is essential, especially if septic joint, vascular or compartment issues, or open fractures are suspected.

Uric acid levels correlate with the severity of diabetic sensorimotor polyneuropathy

INTRODUCTION

Diabetic sensorimotor polyneuropathy (DSP) is the most frequent complication in patients with diabetes mellitus (DM), and is associated with age, DM duration, and HbA1c levels. In addition, higher uric acid (UA) levels are reported in patients with DSP.

OBJECTIVES

To explore whether UA levels correlate with DSP severity.

METHODS

We extracted the demographic data, clinical history, neurological and electrophysiological examinations and laboratory findings of 115 patients diagnosed with DSP from January 2012 to December 2015.

RESULTS

The mean age of the total cohort was 62±13years, with 61% men. A positive correlation was demonstrated between uric acid levels and increasing sensory symptoms, and more abnormal electrophysiological findings and vibration perception thresholds. In addition, correlations with gait abnormality, the presence of paraproteinemia and creatine kinase levels were found.

DISCUSSION

Our study results show that uric acid levels correlate with clinical and electrophysiological severity of DSP, providing additional evidence for the relationship between the two, and a potential therapeutic target for DSP.