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Normal Variants in Musculoskeletal Development

Normal variants refer to normal development of the musculoskeletal system, in particular the lower limbs. It is important to know about them as they are a common cause for concern for parents and a frequent reason for consultation. 

Normal variants include leg alignment issues, flat feet, knock-knees, bow-legs, out-toeing, in-toeing or toe-walking. 

It is important to understand normal gait and motor milestones and know about normal lower limb development in order to appreciate when observations may be considered abnormal, what conditions to consider and when to refer for a specialist opinion.

Often, explanation and reassurance for parents may suffice, but practitioners should be confident in knowing when this is appropriate, and when referral for further specialist assessment may be necessary.

Further information on normal variants is available.

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