Hutchinson syndrome


Limping child, really? If a child does not want to sit, radiologists and clinicians should think that there is no reason for this child to be uncomfortable upon sitting if there is a hip, knee, ankle or lower limb disorder. The radiologist should be aware of spine affections such as infectious spondylodiskitis, or as in this case, bone metastases (of a neuroblastoma). Spine MRI, or as in this case, bone scintigraphy, should be performed without delay.

Hutchinson syndrome is limping and irritability due to skeletal metastases and is a confusing yet classical presentation of a metastatic neuroblastoma. 

Multiple bone metastases in a toddler should first raise suspicion of a neuroblastoma.