Assessment of non-traumatic foot and ankle conditions in children

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed assessment of non-traumatic foot and ankle conditions in children with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Suspected bone or joint infection (e.g. red-hot swollen joint, or child is unwell or febrile)

Limping child with any of the following — acute onset, severe localised joint pain

Limping child with any of the following — concern for non-accidental injury

Limping child with any of the following — nocturnal symptoms

Limping child with any of the following — persistent limp (longer than 7 days) that is not improving

Limping child with any of the following — petechiae or purpura

Limping child with any of the following — suspicious for malignancy

Limping child with any of the following — systemic symptoms (e.g. fever, weight loss)

Routine referral criteria

Determine Category 2 or 3 urgency.

Usually managed in primary care

Cosmetic concerns about the foot or toes without pain, progression or functional impairment (e.g. incidental finding of accessory bones or cartilage, hallux valgus without pain or functional limitation, tarsal coalition that is manageable or without pain)
Congenital curly toes
Flexible flat feet with no pain, or pain that is manageable with orthotics
Intermittent toe walking
Sever’s disease
Symmetrical in-toeing in a child less than 4 years or without functional impairment or patellofemoral symptoms