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Clinical and radiographic evaluation of bowlegs
1Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. TweeDo@chmcc.org
Insights
Physiologic genu varum (bowleggedness) is common in young children and usually resolves. Significant bowing after age 2 warrants investigation for conditions like infantile Blount
Area of Science:
- Pediatrics
- Orthopedics
- Developmental Biology
Background:
- Lower extremity bowing is a normal developmental process in children under 2 years.
- Persistent or significant bowing after age 2 is considered abnormal and requires medical evaluation.
- Infantile Blount's disease is a common pathological cause, particularly in obese children with early walking onset.
Purpose of the Study:
- To differentiate between normal physiologic genu varum and abnormal bowleggedness.
- To identify potential causes of pathological lower extremity bowing.
- To inform appropriate management strategies for abnormal bowing.
Main Methods:
- Clinical observation of pediatric patients with lower extremity bowing.
- Review of differential diagnoses including infections, trauma, genetic, and metabolic factors.
- Emphasis on distinguishing physiologic genu varum from pathological conditions.
Main Results:
- Physiologic genu varum typically resolves spontaneously.
- Abnormal bowing may indicate underlying conditions such as infantile Blount's disease.
- Obesity and early walking are associated with increased risk of infantile Blount's disease.
Conclusions:
- Accurate diagnosis is crucial to differentiate physiologic genu varum from pathological causes.
- Early identification of abnormal bowing is essential for timely intervention.
- Treatment for pathological bowing may involve bracing or surgical options.
Abstract:
Lower extremity bowing is a normal physiologic process that commonly occurs in walking children under the age of 2 years. After this age, any significant amount of residual bowing is abnormal and may be due to infections, traumatic physeal injuries, genetic predisposition, metabolic factors, or a combination of these. Of the pathologic conditions, infantile Blount's disease is the most common and is predominantly found in obese children with an early onset of walking. Because of its frequency in occurrence and general tendency for spontaneous resolution, physiologic genu varum must be clearly distinguished from other pathologic processes that result in bowleggedness. Treatment of the latter cases may consist of early bracing or surgery.