Addressing pediatric intoeing in primary care

Area of Science:

• Pediatric orthopedics
• Primary care medicine
• Developmental pediatrics

Background:

• Intoeing, a common gait abnormality in children, is frequently encountered by primary care providers.
• Most cases of intoeing represent normal developmental variations that do not require intervention.
• Identifying children needing specialist referral is crucial for appropriate management.

Purpose of the Study:

• To equip primary care nurse practitioners (NPs) with the knowledge to differentiate normal intoeing from conditions requiring referral.
• To outline key historical, physical examination, and red flag findings for identifying children with intoeing who need further evaluation.

Main Methods:

• Review of current literature on pediatric intoeing and its management.
• Emphasis on the role of primary care providers, particularly NPs, in the initial assessment.
• Guidance on utilizing patient history, physical examination, and red flag indicators.

Main Results:

• Intoeing is a common pediatric condition, with the vast majority resolving spontaneously.
• Specific historical factors and physical examination findings can help identify atypical cases.
• Red flags, such as asymmetry, pain, or neurological deficits, warrant further investigation.

Conclusions:

• Primary care NPs play a vital role in managing children with intoeing.
• A thorough assessment including history, physical exam, and red flag identification enables appropriate referral decisions.
• Early identification of concerning cases ensures timely intervention and optimal outcomes for children with intoeing.