FIGURE 46.1 Algorithmic approach to the child with a limp AVN, avascular necrosis; CBC, complete blood cell count; CRPS, complex regional pain syndrome; DDH, developmental dysplasia of the hip; LCP, Legg–Calvé–Perthes disease; SCFE, slipped capital femoral epiphysis Systemic bone or soft tissue involvement can lead to limping without localization of limb findings A painful limp without localization or with migratory bone pain may suggest a hematologic or oncologic cause, such as sickle cell disease or leukemia Limping with bilateral leg pain localized to the muscles, especially the calves, suggests myositis Benign acute childhood myositis is common during influenza epidemics Recurrent diffuse aches after