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).
Photo: Severe Varus in Achondroplasia
Diagram below - short limbs compared to trunk in Achondroplasia