Case history
Case history #1
A 2-year-old boy is brought to the orthopaedic clinic by his mother, who is concerned that her son keeps falling down and "walks with his feet turning in". His mother has noticed this for the past year. The toddler was recently seen by his paediatrician, who thought that his problem was probably normal but suggested evaluation by an orthopaedic specialist. His mother anxiously asks whether he needs braces. She recalls that her aunt needed leg braces as a child but is unsure of the problem that was being treated. The obstetric history is unremarkable and his developmental milestones are normal.
Case history #2
A 5-year-old girl is referred to the orthopaedic clinic with a history of walking with her toes pointing inward. Her parents are concerned that the in-toeing has become worse over the past year. The mother has tried encouraging her child to walk with her feet turning out with no improvement in her gait and she insists that something be done. The mother describes having had the same problem as a child. The child is able to sit in the W position. [Figure caption and citation for the preceding image starts]: Photo of a child sitting in the W positionFrom the collection of Tamir Bloom, MD [Citation ends].
The obstetric history was unremarkable and her developmental milestones were normal.
Other presentations
Children may develop chronic complaints of anterior knee pain and be unable to continue sporting activities because of pain. Paediatricians may diagnose chondromalacia patellae, with non-steroidal analgesics providing minimal relief of symptoms. Pain may be exacerbated by physical activities. Parents may describe having the same problem when they were children, in addition to having their patella dislocated multiple times during later life, which has limited physical activities. While standing, the child's patella may point medially (sometimes described as cross-eyed or squinting patella). The child may run awkwardly, described as an eggbeater running style.
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