II. Physiology: Normal course

  1. Birth: Maximal varus
  2. Age 2 years: Neutral position
  3. Ages 3-4 years: Maximal valgus (>10 degrees)
  4. Age >10 years: Anatomic valgus at 6 degrees
  5. Valgus deformity persists more in girls than boys

III. Signs

  1. Knock-Kneed appearance
  2. Evaluate standing knee alignment
    1. Intercondylar distance
    2. Intermalleolar distance
    3. Tibiofemoral angle

IV. Precautions

  1. Onset as teen is unusual and warrants referral
  2. Atypical acquired cases may result from Trauma, prior Osteomyelitis or Fracture

V. Differential Diagnosis (Pathologic Genu Valgum)

  1. Rickets
  2. Diastrophic dysplasia
  3. Morquio's Syndrome
  4. Ellis-van Creveld or Chondroectodermal Dysplasia
  5. Spondyloepiphyseal Dysplasia
  6. Pseudoachondroplasia

VI. Complications

  1. Premature Osteoarthritis

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