The differential in the case was confirmed through appropriate imaging, and the patient was diagnosed with neuroblastoma on the initial visit with CT. Although neuroblastoma can often present with a wide range of symptoms including an abdominal mass, constipation, periorbital ecchymoses ("raccoon eyes"), paraspinal masses, back pain, opsoclonus-myoclonus syndrome, this patient presented only with a limp.  The child was within the typical age range for neuroblastoma, which is commonly diagnosed between the ages of 1 and 5 years old. 

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center