Leg length discrepancy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(52 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{SI}}
{{SI}}
{{CMG}}
{{CMG}}; {{AE}} {{VR}}
 
{{SK}} Unequal leg length, leg length inequality, leg length alignment asymmetry
 
==Overview==
Leg length discrepancy is a medical condition where the [[leg]]s are of different sizes.  There are two main types of leg length inequalities.  The first type is caused by the legs themselves being measurably different in length as seen in [[birth defect]]s, [[fracture|broken leg]] or serious [[infection]].  The other, more common, type is refereed to as leg length alignment asymmetry, a condition where the short leg is unequal in length while in a supine or prone position.  Leg length alignment asymmetry can be the result of hypertonicity in the musculature of the [[pelvis]] or [[leg]].<ref>[http://www.chiroandosteo.com/content/13/1/12 Knutson, G. A. "Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry".] Chiropractic & Osteopathy 2005, 13:12 doi:10.1186/1746-1340-13-12.</ref>
 
==Classification==
===Structural Leg Length Discrepancy===
Structural leg length discrepancy is caused by the legs themselves being measurably different in length, usually due to differences in the length of the [[femur]] in the thigh or the [[tibia]] and [[fibula]] bones in the lower leg.  This may be a [[birth defect]] or it may occur after a [[trauma|broken leg]], serious [[infection]], or local damage to one of the [[growth plate]]s in a leg.
 
===Functional Leg Length Discrepancy===
The other, more common, type is seen when the legs themselves are the same length, but due to [[neuromuscular]] injuries in the [[human pelvis|pelvis]] or upper leg, one leg or hip is held higher and tighter than the other ([[hypertonicity]] in the musculature of the pelvis or leg).  These unequally tightened muscles cause the legs to seem to be different lengths, even though careful measurement would show equal lengths of the actual leg.  This is called leg length alignment asymmetry and can be seen while lying down.<ref>Knutson, G. A.[http://www.chiroandosteo.com/content/13/1/12 "Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry".] ''Chiropractic & Osteopathy'', 2005, 13:12 {{doi|10.1186/1746-1340-13-12}}.</ref>


==Causes==
==Causes==
===Common Causes<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
===Life Threatening Causes ===
*[[Cerebral Palsy]]
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
* Hypervascularity after [[fracture]]
 
* [[Infection]]
*[[Appendicitis]]
* [[Juvenile Rheumatoid Arthritis]]
*[[Aortoiliac occlusive disease |Leriche syndrome]]
* [[Poliomyelitis]]
*[[Meningitis]]
* [[Trauma]]
*[[Osteomyelitis]]
* [[Tumor]]
*[[Pelvic abscess]]
* Unilateral [[hyperplasia]]
*[[Psoas abscess]]
* Unilateral [[hypoplasia]]
*[[Septic arthritis]]
*[[Testicular torsion]]
 
===Common Causes===
*[[Avascular necrosis | Avascular necrosis of the hip]]
*[[Cerebral palsy]]
*[[Hip dysplasia (human) | Congenital dysplasia of the hip]]
*[[Discitis]]
*[[Femur fracture]]
*[[Contracture|Hip contractures]]
*[[Legg-Calvé-Perthes syndrome]]
*[[Scoliosis | Lumbar scoliosis]]
*[[Bone tumor | Malignant bone tumors]]
*[[Osteochondritis dissecans]]
*[[Osteomyelitis]]
*[[Salter-Harris fracture]]
*[[Septic arthritis]]
*[[Slipped capital femoral epiphysis]]
*[[Transient synovitis | Transient synovitis of the hip]]<ref name="Gurney-2002">{{Cite journal  | last1 = Gurney | first1 = B. | title = Leg length discrepancy. | journal = Gait Posture | volume = 15 | issue = 2 | pages = 195-206 | month = Apr | year = 2002 | doi =  | PMID = 11869914 }}</ref><ref name="Raczkowski-2010">{{Cite journal  | last1 = Raczkowski | first1 = JW. | last2 = Daniszewska | first2 = B. | last3 = Zolynski | first3 = K. | title = Functional scoliosis caused by leg length discrepancy. | journal = Arch Med Sci | volume = 6 | issue = 3 | pages = 393-8 | month = Jun | year = 2010 | doi = 10.5114/aoms.2010.14262 | PMID = 22371777 }}</ref><ref name="Coppola-1999">{{Cite journal  | last1 = Coppola | first1 = C. | last2 = Maffulli | first2 = N. | title = Limb shortening for the management of leg length discrepancy. | journal = J R Coll Surg Edinb | volume = 44 | issue = 1 | pages = 46-54 | month = Feb | year = 1999 | doi =  | PMID = 10079669 }}</ref>
 
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Atherosclerosis]],  [[AV fistula]],  [[Peripheral arterial disease | claudication of limb]],  [[Cystic medial necrosis|Erdheim cystic medial necrosis]],  [[Osteochondritis|Freiberg's disease]],  [[hemangioma]],  [[hypertension]],  [[Klippel-Trenaunay-Weber syndrome]],  [[Aortoiliac occlusive disease | Leriche syndrome]],  [[limb ischemia]],  [[Parkes Weber syndrome]],  [[peripheral vascular disease]],  [[rheumatic disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Cellulitis]],  [[dermatomyositis]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Avascular necrosis | Avascular necrosis of the hip]],  [[myositis]],  [[serum sickness]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Epiphyseal plate |Arrest of physeal growth]],  [[hyperparathyroidism]],  [[juvenile osteoporosis]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Appendicitis]],  [[inflammatory bowel disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Hemimelia | Fibular hemimelia]],  [[Klippel-Trenaunay-Weber syndrome]],  [[osteochondritis dissecans]],  [[osteogenesis imperfecta]],  [[proteus syndrome]],  [[Russell-Silver syndrome]],  [[tarsal coalition]],  [[Upington disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Acute lymphoblastic leukemia]],  [[Avascular necrosis | avascular necrosis of the hip]],  [[hemarthrosis]],  [[hemophilia]],  [[Multiple myeloma|Kahler's disease]],  [[Langerhans' cell histiocytosis]],  [[leukemia]],  [[myelodysplasia]],  [[sickle-cell disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| [[Hip replacement]],  [[intramuscular injection|immunization (intramuscular injection)]],  [[osteostimulation]],  [[Hip replacement|prosthetic hip replacement]],  [[radiation therapy]],  [[sympathectomy]]
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Acute rheumatic fever]],  [[athlete's foot]],  [[cellulitis]],  [[discitis]],  [[epididymitis]],  [[Abscess|epidural abscess of the spine]],  [[Neisseria gonorrhoeae|gonoccoccal arthritis]],  [[hand-foot-mouth disease]],  [[Adenitis|iliac adenitis]],  [[Lymphadenopathy|inguinal lymphadenitis]],  [[Chronic recurrent multifocal osteomyelitis|juvenile chronic recurrent multifocal osteomyelitis]],  [[Lyme disease|Lyme arthritis]],  [[meningitis]],  [[myositis]],  [[Transient synovitis|observation hip syndrome]],  [[orchitis]],  [[osteomyelitis]],  [[paronychia ]],  [[pelvic abscess]],  [[pelvic inflammatory disease]],  [[perirectal abscess]],  [[poliomyelitis]],  [[psoas abscess]],  [[reactive arthritis]],  [[sacroiliitis]],  [[septic arthritis]],  [[Transient synovitis | transient synovitis of the hip]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Arthropathy]],  [[Baker's cyst]],  [[Blount's disease]],  [[chondroblastoma]],  [[Chondromalacia patellae|chondromalacia of the patella]],  [[Club foot|congenital club foot]],  [[Hip dysplasia (human) | congenital dysplasia of the hip]],  [[Amelia (birth defect)|congenital limb aplasia]],  [[Dysmelia|congenital limb hypoplasia]],  [[Neurofibromatosis type I|congenital pseudarthrosis of the tibia]],  [[Rocker bottom foot|congenital vertical talus]],  [[coxa vara]],  [[dermatomyositis]],  [[discitis]],  [[distraction]],  [[Muscle atrophy|disuse muscle atrophy]],  [[dystonia]],  [[enchondroma]],  [[Cystic medial necrosis|Erdheim cystic medial necrosis]],  [[fallen arches]],  [[Hemimelia | fibular hemimelia]],  [[gait abnormality]],  [[genu recurvatum]],  [[greenstick fracture]],  [[Bone healing|healed fractures]],  [[hemihypertrophy]],  [[Spinal disc herniation|herniated vertebral disc]],  [[Subluxation|hip subluxation]],  [[Contracture|hip contractures]],  [[hypermobility syndrome]],  [[Bone fracture|hypervascularity after fracture]],  [[juvenile arthritis]],  [[juvenile osteoporosis]],  [[juvenile rheumatoid arthritis]],  [[Klippel-Trenaunay-Weber syndrome]],  [[Kohler disease]],  [[Legg-Calvé-Perthes syndrome]],  [[Scoliosis | lumbar scoliosis]], [[Bone tumor|benign bone tumours]],  [[Neuroblastoma|metastatic neuroblastoma]],  [[multiple hereditary exostoses]],  [[muscular dystrophy]],  [[Ollier's disease]],  [[ORIF|open reduction and internal fixation of fractures]],  [[Osgood-Schlatter disease]],  [[osteoblastoma]],  [[osteochondritis dissecans]],  [[osteogenesis imperfecta]],  [[Osteoma|osteoid osteoma]],  [[osteosclerosis]],  [[osteostimulation]],  [[Repetitive strain injury|overuse syndrome]],  [[Chondromalacia patellae|patellofemoral pain syndrome]],  [[Bone fracture|plastic deformation in pediatric fractures]],  [[Paralysis|prolonged immobilization]],  [[proteus syndrome]],  [[proximal femoral focal deficiency]],  [[rheumatic disease]],  [[sciatica]],  [[Sever's disease]],  [[Osgood-Schlatter disease|Sinding-Larsen-Johansson disease]],  [[skeletal dysplasia]],  [[SLE]],  [[slipped capital femoral epiphysis]],  [[Spina bifida|spinal dysraphism]],  [[spondylolisthesis]],  [[Tarsal coalition|tarsal synostosis]],  [[tendonitis]],  [[tenosynovitis]],  [[Upington disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Brain tumor]],  [[cerebral palsy]],  [[dystonia]],  [[Contracture|hip contractures]],  [[Scoliosis | lumbar scoliosis]],  [[meningitis]],  [[Neuroblastoma|metastatic neuroblastoma]],  [[multiple sclerosis]],  [[neurofibromatosis]],  [[neurofibrosarcoma]],  [[peripheral neuropathy]],  [[poliomyelitis]],  [[sciatica]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"|[[Epiphyseal plate |  Arrest of physeal growth]],  [[arthropathy]],  [[juvenile osteoporosis]],  [[Scoliosis | lumbar scoliosis]],  [[obesity]],  [[rickets ]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Pelvic inflammatory disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Acute lymphoblastic leukemia]],  [[Bone tumor|benign bone tumours]],  [[brain tumor]],  [[chondroblastoma]],  [[Ewings sarcoma]],  [[Langerhans' cell histiocytosis]],  [[leukemia]],  [[Bone tumor|malignant bone tumors]], [[malignant fibrous histiocytoma]],   [[Neuroblastoma|metastatic neuroblastoma]],  [[neurofibrosarcoma]],  [[osteoblastoma]],  [[osteosarcoma]],  [[spinal cord]] [[tumour]], [[Epiphyseal plate|tumour across epiphyseal plate]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Conversion disorder]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Wilm's tumor]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Acute rheumatic fever]],  [[ankylosing spondylitis]],  [[arthropathy]],  [[Baker's cyst]],  [[dermatomyositis]],  [[Henoch-Schönlein purpura]],  [[Spinal disc herniation|herniated vertebral disc]],  [[inflammatory bowel disease]],  [[juvenile arthritis]],  [[juvenile rheumatoid arthritis]],  [[myositis]],  [[reactive arthritis]],  [[rheumatic disease]],  [[rheumatoid arthritis]],  [[sacroiliitis]],  [[serum sickness]],  [[SLE]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[Epididymitis]],  [[testicular torsion]],  [[orchitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Ankle sprain]],  [[arthralgia]],  [[Avascular necrosis | avascular necrosis of the hip]],  [[Avulsion fracture|avulsion injury]],  [[child abuse]],  [[complex regional pain syndrome]],  [[contusion]],  [[coxa vara]],  [[discitis]],  [[femur]] [[fracture]],  [[Polio|fixed pelvic obliquity]],  [[Foreign body|foot foreign body]],  [[Bone fracture|foot fractures]],  [[Osteochondritis|Freiberg's disease]],  [[greenstick fracture]],  [[Hematoma|hematoma of thigh]],  [[Bone fracture|healed fractures]],  [[hemarthrosis]],  [[Spinal disc herniation|herniated vertebral disc]],  [[hip dislocation]],  [[Subluxation|hip subluxation]],  [[Bone fracture|hypervascularity after fracture]],  [[testicular torsion]],  [[knee sprain]],  [[limb ischemia]],  [[Bone fracture|malunion]],  [[muscle strain]],  [[femur fracture]],  [[Fracture nonunion|nonunion]],  [[Transient synovitis|observation hip syndrome]],  [[ORIF|open reduction and internal fixation of fractures]], [[patellar dislocation]],  [[Chondromalacia patellae|patellofemoral pain syndrome]],  [[periostitis]],  [[Achilles tendon|ruptured achilles tendon]],  [[sacroiliitis]],  [[Salter-Harris fracture]],  [[sciatica]],  [[spondylolisthesis]],  [[stress fracture]],  [[tendonitis]],  [[tenosynovitis]],  [[Bone fracture classification|tibial fracture]],  [[toddler fracture]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
 
===Causes in Alphabetical Order===
{{col-begin|width=85%}}
{{col-break|width=33%}}
*[[Acute lymphoblastic leukemia]]
*[[Acute rheumatic fever]]
*[[Ankle sprain]]
*[[Ankylosing spondylitis]]
*[[Osgood-Schlatter disease|Apophysitis]]
*[[Appendicitis]]
* [[Epiphyseal plate | Arrest of physeal growth]]
*[[Arthralgia]]
*[[Arthropathy]]
*[[Atherosclerosis]]
*[[Athlete's foot]]
*[[AV fistula]]
*[[Avascular necrosis | Avascular necrosis of the hip]]
*[[Avulsion fracture|Avulsion injury]]
*[[Baker's cyst]]
*[[Bone tumor|Benign bone tumours]]
*[[Blount's disease]]
*[[Brain tumor]]
*[[Cellulitis]]
*[[Cerebral palsy]]
*[[Child abuse]]
*[[Chondroblastoma]]
*[[Chondromalacia patellae]]
*[[Peripheral arterial disease | Claudication of limb]]
*[[Complex regional pain syndrome]]
*[[Club foot|Congenital club foot]]
*[[Hip dysplasia (human) | Congenital dysplasia of the hip]]
*[[Amelia (birth defect)|Congenital limb aplasia]]
*[[Dysmelia|Congenital limb hypoplasia]]
*[[Neurofibromatosis type I|Congenital pseudarthrosis of the tibia]]
*[[Rocker bottom foot|Congenital vertical talus ]]
*[[Contusion]]
*[[Conversion disorder]]
*[[Coxa vara]]
*[[Dermatomyositis]]
*[[Discitis]]
*[[Distraction]]
*[[Muscle atrophy|Disuse muscle atrophy]]
*[[Dystonia]]
*[[Enchondroma]]
*[[Epididymitis]]
*[[Abscess|Epidural abscess of the spine]]
*[[Cystic medial necrosis|Erdheim cystic medial necrosis]]
*[[Ewings sarcoma]]
*[[Fallen arches]]
*[[Femur fracture]]
*[[Hemimelia | Fibular hemimelia]]
*[[Polio|Fixed pelvic obliquity]]<ref name="Lee-1997">{{Cite journal  | last1 = Lee | first1 = DY. | last2 = Choi | first2 = IH. | last3 = Chung | first3 = CY. | last4 = Cho | first4 = TJ. | last5 = Lee | first5 = JC. | title = Fixed pelvic obliquity after poliomyelitis: classification and management. | journal = J Bone Joint Surg Br | volume = 79 | issue = 2 | pages = 190-6 | month = Mar | year = 1997 | doi =  | PMID = 9119840 }}</ref>
*[[Foreign body|Foot foreign body]]
*[[Bone fracture|Foot fractures]]
*[[Osteochondritis|Freiberg disease]]
*[[Gait abnormality]]
*[[Genu recurvatum]]
*[[Greenstick fracture]]
*[[Neisseria gonorrhoeae|Gonoccoccal arthritis]]
*[[Hand-foot-mouth disease]]
*[[Bone healing|Healed fractures]]
*[[Hemangioma]]
{{col-break|width=33%}}
*[[Hemarthrosis]]
*[[Hematoma|Hematoma of thigh]]
*[[Hemihypertrophy]]
*[[Hemophilia]]
*[[Henoch-Schonlein purpura]]
*[[Spinal disc herniation|Herniated vertebral disc]]
*[[Hip dislocation]]
*[[Hip replacement]]
*[[Subluxation|Hip subluxation]]
*[[Contracture|Hip contractures]]
*[[Hypermobility syndrome]]
*[[Hyperparathyroidism]]
*[[Hypertension]]
*[[Bone fracture|Hypervascularity after fracture]]
*[[Idiopathic]]
*[[Adenitis|Iliac adenitis]]
*[[intramuscular injection|Immunization (intramuscular injection)]]
*[[Inflammatory bowel disease]]
*[[Lymphadenopathy|inguinal lymphadenitis]]
*[[Juvenile arthritis]]
*[[Chronic recurrent multifocal osteomyelitis|Juvenile chronic recurrent multifocal osteomyelitis]]
*[[Juvenile osteoporosis]]
*[[Juvenile rheumatoid arthritis]]
*[[Multiple myeloma|Kahler's disease]]
*[[Klippel-Trenaunay-Weber syndrome]]
*[[Knee sprain]]
*[[Kohler disease]]
*[[Langerhans' cell histiocytosis]]
*[[Legg-Calvé-Perthes syndrome]]
*[[Aortoiliac occlusive disease | Leriche syndrome]]
*[[Leukemia]]
*[[Limb ischemia]]
*[[Scoliosis | Lumbar scoliosis]]
*[[Lyme disease|Lyme arthritis]]
*[[Bone tumor | Malignant bone tumors]]
*[[Malignant fibrous histiocytoma]]
*[[Bone fracture|Malunion]]
*[[Meningitis]]
*[[Neuroblastoma|Metastatic neuroblastoma]]
*[[Multiple hereditary exostoses]]
*[[Multiple sclerosis]]
*[[Muscle strain]]
*[[Muscular dystrophy]]
*[[Myelodysplasia]]
*[[Myositis]]
*[[Femur fracture|Neck of femur fracture]]
*[[Neurofibromatosis]]
*[[Neurofibrosarcoma]]
*[[Fracture nonunion|Nonunion]]
*[[Obesity]]
*[[Transient synovitis|Observation hip syndrome]]<ref name="FERNANDEZDE VALDERRAMA-1963">{{Cite journal  | last1 = FERNANDEZDE VALDERRAMA | first1 = . | title = THE OBSERVATION HIP SYNDROME AND ITS LATE SEQUELAE. | journal = J Bone Joint Surg Br | volume = 45 | issue =  | pages = 462-70 | month = Aug | year = 1963 | doi =  | PMID = 14065262 }}</ref>
*[[Ollier's disease]]
*[[ORIF|Open reduction and internal fixation of fractures]]
*[[Orchitis]]
*[[Osgood-Schlatter disease]]
*[[Osteoblastoma]]
*[[Osteochondritis dissecans]]
{{col-break|width=33%}}
*[[Osteogenesis imperfecta]]
*[[Osteosclerosis]]
*[[Osteostimulation]]
*[[Osteosarcoma]]
*[[Osteoma|Osteoid osteoma]]
*[[Osteomyelitis]]
*[[Repetitive strain injury|Overuse syndrome]]
*[[Parkes Weber syndrome]]
*[[Paronychia ]]
*[[Patellar dislocation]]
*[[Chondromalacia patellae|Patellofemoral pain syndrome]]
*[[Pelvic abscess]]
*[[Pelvic inflammatory disease]]
*[[Periostitis]]
*[[Peripheral neuropathy]]
*[[Peripheral vascular disease]]
*[[Perirectal abscess]]
*[[Bone fracture|Plastic deformation in pediatric fractures]]
*[[Poliomyelitis]]
*[[Paralysis|Prolonged immobilization ]]
*[[Hip replacement|Prosthetic hip replacement]]
*[[Proteus syndrome]]
*[[Proximal femoral focal deficiency]]
*[[Psoas abscess]]
*[[Radiation therapy]]
*[[Reactive arthritis]]
*[[Rheumatic disease]]
*[[Rheumatoid arthritis]]
*[[Rickets ]]
*[[Achilles tendon|Ruptured achilles tendon]]
*[[Russell-Silver syndrome]]
*[[Sacroiliitis]]
*[[Salter-Harris fracture]]
*[[Sciatica]]
*[[Septic arthritis]]
*[[Serum sickness]]
*[[Sever's disease]]
*[[Sickle-cell disease ]]
*[[Osgood-Schlatter disease|Sinding-Larsen-Johansson disease]]
*[[Skeletal dysplasia]]
*[[SLE]]
*[[Slipped capital femoral epiphysis]]
*[[Spinal cord tumor]]
*[[Spina bifida|Spinal dysraphism]]
*[[Spondylolisthesis]]
*[[Stress fracture]]
*[[Sympathectomy]]
*[[Tarsal coalition]]
*[[Tarsal coalition|Tarsal synostosis]]
*[[Tendonitis]]
*[[Tenosynovitis]]
*[[Testicular torsion]]
*[[Bone fracture classification|Tibial fracture]]
*[[Toddler fracture]]
*[[Transient synovitis | Transient synovitis of the hip]]
*[[Upington disease]]
*[[Wilm's tumor]]
{{col-end}}


== References ==
== References ==
{{Reflist|2}}
{{Reflist|2}}


{{WikiDoc Help Menu}}
[[Category:Crowdiagnosis]]
{{WikiDoc Sources}}
 
[[Category:Musculoskeletal Disease]]
[[Category:Musculoskeletal Disease]]
[[Category:Signs and symptoms]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Physical examination]]
[[Category:Physical examination]]
[[Category:Up-To-Date]]
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

Latest revision as of 18:06, 9 June 2015

WikiDoc Resources for Leg length discrepancy

Articles

Most recent articles on Leg length discrepancy

Most cited articles on Leg length discrepancy

Review articles on Leg length discrepancy

Articles on Leg length discrepancy in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Leg length discrepancy

Images of Leg length discrepancy

Photos of Leg length discrepancy

Podcasts & MP3s on Leg length discrepancy

Videos on Leg length discrepancy

Evidence Based Medicine

Cochrane Collaboration on Leg length discrepancy

Bandolier on Leg length discrepancy

TRIP on Leg length discrepancy

Clinical Trials

Ongoing Trials on Leg length discrepancy at Clinical Trials.gov

Trial results on Leg length discrepancy

Clinical Trials on Leg length discrepancy at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Leg length discrepancy

NICE Guidance on Leg length discrepancy

NHS PRODIGY Guidance

FDA on Leg length discrepancy

CDC on Leg length discrepancy

Books

Books on Leg length discrepancy

News

Leg length discrepancy in the news

Be alerted to news on Leg length discrepancy

News trends on Leg length discrepancy

Commentary

Blogs on Leg length discrepancy

Definitions

Definitions of Leg length discrepancy

Patient Resources / Community

Patient resources on Leg length discrepancy

Discussion groups on Leg length discrepancy

Patient Handouts on Leg length discrepancy

Directions to Hospitals Treating Leg length discrepancy

Risk calculators and risk factors for Leg length discrepancy

Healthcare Provider Resources

Symptoms of Leg length discrepancy

Causes & Risk Factors for Leg length discrepancy

Diagnostic studies for Leg length discrepancy

Treatment of Leg length discrepancy

Continuing Medical Education (CME)

CME Programs on Leg length discrepancy

International

Leg length discrepancy en Espanol

Leg length discrepancy en Francais

Business

Leg length discrepancy in the Marketplace

Patents on Leg length discrepancy

Experimental / Informatics

List of terms related to Leg length discrepancy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]

Synonyms and keywords: Unequal leg length, leg length inequality, leg length alignment asymmetry

Overview

Leg length discrepancy is a medical condition where the legs are of different sizes. There are two main types of leg length inequalities. The first type is caused by the legs themselves being measurably different in length as seen in birth defects, broken leg or serious infection. The other, more common, type is refereed to as leg length alignment asymmetry, a condition where the short leg is unequal in length while in a supine or prone position. Leg length alignment asymmetry can be the result of hypertonicity in the musculature of the pelvis or leg.[1]

Classification

Structural Leg Length Discrepancy

Structural leg length discrepancy is caused by the legs themselves being measurably different in length, usually due to differences in the length of the femur in the thigh or the tibia and fibula bones in the lower leg. This may be a birth defect or it may occur after a broken leg, serious infection, or local damage to one of the growth plates in a leg.

Functional Leg Length Discrepancy

The other, more common, type is seen when the legs themselves are the same length, but due to neuromuscular injuries in the pelvis or upper leg, one leg or hip is held higher and tighter than the other (hypertonicity in the musculature of the pelvis or leg). These unequally tightened muscles cause the legs to seem to be different lengths, even though careful measurement would show equal lengths of the actual leg. This is called leg length alignment asymmetry and can be seen while lying down.[2]

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Atherosclerosis, AV fistula, claudication of limb, Erdheim cystic medial necrosis, Freiberg's disease, hemangioma, hypertension, Klippel-Trenaunay-Weber syndrome, Leriche syndrome, limb ischemia, Parkes Weber syndrome, peripheral vascular disease, rheumatic disease
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic Cellulitis, dermatomyositis
Drug Side Effect Avascular necrosis of the hip, myositis, serum sickness
Ear Nose Throat No underlying causes
Endocrine Arrest of physeal growth, hyperparathyroidism, juvenile osteoporosis
Environmental No underlying causes
Gastroenterologic Appendicitis, inflammatory bowel disease
Genetic Fibular hemimelia, Klippel-Trenaunay-Weber syndrome, osteochondritis dissecans, osteogenesis imperfecta, proteus syndrome, Russell-Silver syndrome, tarsal coalition, Upington disease
Hematologic Acute lymphoblastic leukemia, avascular necrosis of the hip, hemarthrosis, hemophilia, Kahler's disease, Langerhans' cell histiocytosis, leukemia, myelodysplasia, sickle-cell disease
Iatrogenic Hip replacement, immunization (intramuscular injection), osteostimulation, prosthetic hip replacement, radiation therapy, sympathectomy
Infectious Disease Acute rheumatic fever, athlete's foot, cellulitis, discitis, epididymitis, epidural abscess of the spine, gonoccoccal arthritis, hand-foot-mouth disease, iliac adenitis, inguinal lymphadenitis, juvenile chronic recurrent multifocal osteomyelitis, Lyme arthritis, meningitis, myositis, observation hip syndrome, orchitis, osteomyelitis, paronychia , pelvic abscess, pelvic inflammatory disease, perirectal abscess, poliomyelitis, psoas abscess, reactive arthritis, sacroiliitis, septic arthritis, transient synovitis of the hip
Musculoskeletal/Orthopedic Arthropathy, Baker's cyst, Blount's disease, chondroblastoma, chondromalacia of the patella, congenital club foot, congenital dysplasia of the hip, congenital limb aplasia, congenital limb hypoplasia, congenital pseudarthrosis of the tibia, congenital vertical talus, coxa vara, dermatomyositis, discitis, distraction, disuse muscle atrophy, dystonia, enchondroma, Erdheim cystic medial necrosis, fallen arches, fibular hemimelia, gait abnormality, genu recurvatum, greenstick fracture, healed fractures, hemihypertrophy, herniated vertebral disc, hip subluxation, hip contractures, hypermobility syndrome, hypervascularity after fracture, juvenile arthritis, juvenile osteoporosis, juvenile rheumatoid arthritis, Klippel-Trenaunay-Weber syndrome, Kohler disease, Legg-Calvé-Perthes syndrome, lumbar scoliosis, benign bone tumours, metastatic neuroblastoma, multiple hereditary exostoses, muscular dystrophy, Ollier's disease, open reduction and internal fixation of fractures, Osgood-Schlatter disease, osteoblastoma, osteochondritis dissecans, osteogenesis imperfecta, osteoid osteoma, osteosclerosis, osteostimulation, overuse syndrome, patellofemoral pain syndrome, plastic deformation in pediatric fractures, prolonged immobilization, proteus syndrome, proximal femoral focal deficiency, rheumatic disease, sciatica, Sever's disease, Sinding-Larsen-Johansson disease, skeletal dysplasia, SLE, slipped capital femoral epiphysis, spinal dysraphism, spondylolisthesis, tarsal synostosis, tendonitis, tenosynovitis, Upington disease
Neurologic Brain tumor, cerebral palsy, dystonia, hip contractures, lumbar scoliosis, meningitis, metastatic neuroblastoma, multiple sclerosis, neurofibromatosis, neurofibrosarcoma, peripheral neuropathy, poliomyelitis, sciatica
Nutritional/Metabolic Arrest of physeal growth, arthropathy, juvenile osteoporosis, lumbar scoliosis, obesity, rickets
Obstetric/Gynecologic Pelvic inflammatory disease
Oncologic Acute lymphoblastic leukemia, benign bone tumours, brain tumor, chondroblastoma, Ewings sarcoma, Langerhans' cell histiocytosis, leukemia, malignant bone tumors, malignant fibrous histiocytoma, metastatic neuroblastoma, neurofibrosarcoma, osteoblastoma, osteosarcoma, spinal cord tumour, tumour across epiphyseal plate
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Conversion disorder
Pulmonary No underlying causes
Renal/Electrolyte Wilm's tumor
Rheumatology/Immunology/Allergy Acute rheumatic fever, ankylosing spondylitis, arthropathy, Baker's cyst, dermatomyositis, Henoch-Schönlein purpura, herniated vertebral disc, inflammatory bowel disease, juvenile arthritis, juvenile rheumatoid arthritis, myositis, reactive arthritis, rheumatic disease, rheumatoid arthritis, sacroiliitis, serum sickness, SLE
Sexual Epididymitis, testicular torsion, orchitis
Trauma Ankle sprain, arthralgia, avascular necrosis of the hip, avulsion injury, child abuse, complex regional pain syndrome, contusion, coxa vara, discitis, femur fracture, fixed pelvic obliquity, foot foreign body, foot fractures, Freiberg's disease, greenstick fracture, hematoma of thigh, healed fractures, hemarthrosis, herniated vertebral disc, hip dislocation, hip subluxation, hypervascularity after fracture, testicular torsion, knee sprain, limb ischemia, malunion, muscle strain, femur fracture, nonunion, observation hip syndrome, open reduction and internal fixation of fractures, patellar dislocation, patellofemoral pain syndrome, periostitis, ruptured achilles tendon, sacroiliitis, Salter-Harris fracture, sciatica, spondylolisthesis, stress fracture, tendonitis, tenosynovitis, tibial fracture, toddler fracture
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ Knutson, G. A. "Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry". Chiropractic & Osteopathy 2005, 13:12 doi:10.1186/1746-1340-13-12.
  2. ↑ Knutson, G. A."Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry". Chiropractic & Osteopathy, 2005, 13:12 doi:10.1186/1746-1340-13-12.
  3. ↑ Gurney, B. (2002). "Leg length discrepancy". Gait Posture. 15 (2): 195–206. PMID 11869914. Unknown parameter |month= ignored (help)
  4. ↑ Raczkowski, JW.; Daniszewska, B.; Zolynski, K. (2010). "Functional scoliosis caused by leg length discrepancy". Arch Med Sci. 6 (3): 393–8. doi:10.5114/aoms.2010.14262. PMID 22371777. Unknown parameter |month= ignored (help)
  5. ↑ Coppola, C.; Maffulli, N. (1999). "Limb shortening for the management of leg length discrepancy". J R Coll Surg Edinb. 44 (1): 46–54. PMID 10079669. Unknown parameter |month= ignored (help)
  6. ↑ Lee, DY.; Choi, IH.; Chung, CY.; Cho, TJ.; Lee, JC. (1997). "Fixed pelvic obliquity after poliomyelitis: classification and management". J Bone Joint Surg Br. 79 (2): 190–6. PMID 9119840. Unknown parameter |month= ignored (help)
  7. ↑ FERNANDEZDE VALDERRAMA, . (1963). "THE OBSERVATION HIP SYNDROME AND ITS LATE SEQUELAE". J Bone Joint Surg Br. 45: 462–70. PMID 14065262. Unknown parameter |month= ignored (help)


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Leg_length_discrepancy&oldid=1108015"