II. General
- Intoeing encases several underlying leg abnormalities
- Intoeing may occur at any level down leg kinetic chain
- Intoeing causes by age (most common causes)
- Infant: Metatarsus Adductus
- Toddler: Internal Tibial Torsion
- Child: Femoral Anteversion (usually bilateral)
III. Approach
- Step 1: Evaluate gait and rotational profile (Torsional Profile)
- See Foot Progression Angle (Gait Rotational Angle)
- Confirm In-Toeing with Out-toeing
- Level of abnormality may be apparent by gait
- Step 2: Evaluate hip rotation
- See Hip Rotation Evaluation in Children
- Limited lateral hip rotation (less than -10 to 20)
- Step 3: Evaluate Thigh to Foot Angle
- Negative angle suggests Medial Tibial Torsion
- Step 4: Evaluate for foot deformity
- Curved foot suggests Metatarsus Adductus
- Step 5: Evaluate for toe deformity
- Great toe abducted suggests searching toe
IV. References
- Schmale (2003) AAFP Board Review, Seattle
- Rerucha (2017) Am Fam Physician 96(4): 226-33 [PubMed]