Genu Valgum (Knock-Knees)
Knock-knees are normal in young children and most resolve by 6 years of age.
Between the ages of 2 and 4 years, a gap of 6 to 7 cm between the medial malleoli (the bone prominences at the ankles) is regarded as normal.
Referral is necessary if:
- There is asymmetry.
- There is an ankle gap larger than 6-7 cm.
- Changes are associated with pain or functional impairment.
- Changes persist beyond 5 years of age.
Conditions to consider include Rickets, Skeletal Dysplasias or Chronic (untreated) Inflammatory Arthritis.
The picture below shows valgus deformity at both knees with thigh muscle wasting) in untreated Juvenile Idiopathic Arthritis. There is also abnormality at both ankles with calf muscle wasting.