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Benign acute childhood myositis--a rare cause of abnormal gait.

Benign acute childhood myositis is a rare postviral myositis seen in school-aged children after a common upper respiratory infection (URI), most commonly caused by influenza [J Microbiol Immunol Infect 2004;37:95-98]. Predominantly seen in boys, this condition causes bilateral calf tenderness and pain with ambulation, often presenting as a refusal to bear weight. To avoid activation within the gastroc-soleus complex, the child will frequently compensate with a “Frankenstein gait,” described as a stiff-legged posture with shuffling gait [CMAJ 2009;181:711-713]. The child may also walk on his toes or refuse to walk at all. This refusal to bear weight can be alarming to both providers and parents, resulting in extensive workups. We present the case of a 5-year-old boy who presented to the emergency department with a chief complaint of leg pain and refusal to walk. Further history revealed a resolved URI approximately 5 days prior. He was noted to have an elevated creatinine kinase with no evidence of renal insufficiency. He had no progression or complications, and his symptoms resolved spontaneously with minimal supportive treatment. Benign acute childhood myositis should be considered within the broad differential that surrounds a limping child or one who refuses to bear weight. Having insight into the condition with its characteristic gait abnormalities and associated URI history can often prevent extensive workups and be treated supportively in the outpatient setting.

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