II. Physiology: Normal course
- Birth: Maximal varus
- Age 2 years: Neutral position
- Ages 3-4 years: Maximal valgus (>10 degrees)
- Age >10 years: Anatomic valgus at 6 degrees
- Valgus deformity persists more in girls than boys
III. Signs
- Knock-Kneed appearance
- Evaluate standing knee alignment
- Intercondylar distance
- Intermalleolar distance
- Tibiofemoral angle
IV. Precautions
- Onset as teen is unusual and warrants referral
- Atypical acquired cases may result from Trauma, prior Osteomyelitis or Fracture
V. Differential Diagnosis (Pathologic Genu Valgum)
- Rickets
- Diastrophic dysplasia
- Morquio's Syndrome
- Ellis-van Creveld or Chondroectodermal Dysplasia
- Spondyloepiphyseal Dysplasia
- Pseudoachondroplasia
VI. Complications
- Premature Osteoarthritis