Genu valgum (knock knees)

• Normally seen at 30-60 months of age.

Differential diagnosis includes:

• hereditary (often have family history)
• severe renal rickets (usually have other obvious findings)
• Morquio’sdisease (amucopolysaccharidoses, anautosomalrecessive disorder characterized by severe dwarfism,kyphosis,pectus carinatum, vertebralplana, and characteristicfacies)
• an old fracture of the proximal tibia
• old tibial metaphyseal osteomyelitis

PE

• place the child supine with the hip and knees extended, with the femoral condyles(knees) together and measure the intermalleolar distance between the ankles . If the distance is greater than 10 cm, the child should be referred to Ortho

Treatment

• children with less than 10cm of distance between their ankles with their knees held together, with no other positive findings, can be treated with observation alone.
• Bracing may help those children with distance greater than 10cm.

CHLA Board Review 2005