Case history
Case history #1
A 2-year-old boy is brought to the orthopedic 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 pediatrician, who thought that his problem was probably normal but suggested evaluation by an orthopedic specialist. His mother anxiously asks if he needs braces. She recalls that her aunt needed leg braces as a child, but is unsure what the problem was 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 orthopedic clinic with a history of walking with her toes pointing inward. Her parents are concerned that the intoeing has become worse over the past year. The mother has tried encouraging her child to walk with 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. Pediatricians may diagnose chondromalacia patellae, with nonsteroidal 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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