bow legs and knock knees by gdf57j

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                        Top Tips in Two Minutes: Common Conditions in the Normal Child:
                                          Bow Legs and Knock Knees

Why:                  Bow legs- (genu varum) Most children are bow legged from birth until 3 years of age (due to
                      differential growth around the knee)
                      Knock knees (genu valgum) - most children become knock kneed to some degree between
                      3-5, usually grow out of it by about 7.
                      Knock knees will often follow bow legs; usually grow out of one and into the other!
How:
                      Check for asymmetry and pain.
                      Any limp is abnormal


What next and when:   Examine gait.
                      Bow legs – 2 inch rule- no more than 2 inches apart at knee
                      Knock knees; more than 2 inches apart at medial malleoli

Where else:           Red flags (suggested list):
                             Limp.
                             Outside 2 inches rule.
                             Outside typical age range.
                             Unilateral

                      What not to miss-
                           Blounts disease (medial necrosis of medial tibia, heavy children, asymmetrical)
                             causes severe bow legs, more common in afro Caribbean and Scandinavian groups.
                           Metabolic bone disease,
                           Neuromuscular disease.
Web links:            Orthoseek http://www.orthoseek.com/articles/bowlegs-kk.html#valgum

Who are you:          Peter Heinz Consultant Paediatrician Addenbrookes Hospital
                      Anna Maw SpR Paediatrics Addenbrookes Hospital

More                  More top tips can be found at
                      http://www.addenbrookes-pgmc.org.uk/handouts.asp?title=Primary%20Care

Review date:          December 2011




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