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Genu Varum (Bow Legs)

Bow legs (Genu Varum) are common and is considered normal until 2 years of age.

Referral is necessary if: 

  • There are signs of asymmetry
  • Changes are associated with pain or functional impairment (e.g. prone to falling). 
  • Changes are extreme (the femoral intercondylar distance is >6 cm
  • Changes worsen or persist beyond age 4 years.

Conditions to consider include:

Rickets -  look for other clinical signs and if relevant, check bone chemistry (calcium, phosphorus and alkaline phosphatase) and vitamin D; especially if the child is failing to thrive, has generalised aches and pains, or has other risk factors such as a vegan diet, malabsorption syndromes or an ‘at risk’ ethnicity.

Skeletal Dysplasias and dwarfism syndromes such as Achondroplasia - Consider growth and limb proportions (short limbs compared to trunk).

 varus in rckets

Photo: Severe Varus in Achondroplasia

Diagram below - short limbs compared to trunk in Achondroplasia


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