normal_lower_limb_variants_flashcards
What is a common reason for presentation to primary care regarding lower limbs in children?
Apparent abnormalities in the lower limbs of developing children causing parental concern
Describe flat feet (pes planus).
Absent medial arch on standing
What is the typical age of presentation for flat feet?
All ages
What is the management approach for flat feet in children?
Typically resolves between the ages of 4-8 years; orthotics are not recommended; parental reassurance is appropriate
Describe in-toeing.
Common in the first year; possible causes include metatarsus adductus, internal tibial torsion, and femoral anteversion
What are some possible causes of in-toeing in the first year?
Metatarsus adductus, internal tibial torsion, femoral anteversion
What is metatarsus adductus?
Abnormal heel bisector line; 90% of cases resolve spontaneously, severe/persistent cases may require serial casting
What is internal tibial torsion?
Difference between the thigh and foot angle; resolves in the vast majority
What is femoral anteversion?
‘W’ sign; resolves in around 80% by adolescence, surgical intervention in the remaining not usually advised
Describe out-toeing.
Common in all ages, especially early infancy
What is the typical age of presentation for out-toeing?
Usually resolves by the age of 2 years
What is a common cause of out-toeing in early infancy?
External tibial torsion
What is the management approach if out-toeing doesn’t resolve?
Intervention may be appropriate as it increases the risk of patellofemoral pain
Describe bow legs (genu varum).
Increased intercondylar distance
What is the typical age of presentation for bow legs?
1st-2nd year; typically resolves by the age of 4-5 years