II. Types: Antalgic Gait
- Stance phase on unaffected limb is shortened due to pain
- Refusal to bear weight (esp. with limited range of motion, systemic symptoms, fever) suggests Septic Arthritis
III. Types: Non-Antalgic Gait
- Steppage Gait
- Cause: Neurologic deficit interferes with foot dorsiflexion
- Hip and Knee Joints are flexed excessively during swing phase (allows toes to clear ground)
-
Trendelenburg Gait
- Cause: Developmental dysplasia of hip interferes with hip abduction
- Tests: Trandelenburg Test is positive
- Pelvis tilts downward toward the unaffected side during the swing phase
- Circumduction Gait
- Causes
- Limb-length discrepancy (Galeazzi Sign positive)
- Knee or ankle stiffness due to underlying neurologic or mechanical disorder
- Appearance
- Stance phase: Knee is hyperextended and locked
- Swing phase: Affected leg is abducted or circumducted
- Causes
- Equinus Gait
- Causes
- Cerebral Palsy
- Achilles tendon tight
- Calcaneal Fracture
- Foot foreign body
- Limb-length discrepancy
- Appearance
- Toe Walking
- Causes
IV. Exam: Foot Deformity
- Lateral view
- Normal neonatal foot dorsiflexed >90 degrees
- Rule-out fixed equinus (Clubfoot) position
- Tiptoe walking (foot plantar flexed)
- Tight heel cord
- Plantar view (footprint shape)
- Kidney bean (sole deviated medially)
- Banana (sole deviated laterally)
- PA View (from behind, while in neutral position)
- Heel varus with inverted foot (medial malleoli apart)
- Heel valgus with everted foot (medial malleoli touch)
V. Exam: Rotational Deformity
VI. Exam: Angular Deformity
- Genu Varum (bow leg)
- Genu Valgum (knock knee)