Clues to pathologic causes of knock-knees in children

Severe knock-knees (>8 cm between the medial malleoli with patellas facing forward and femoral condyles together)

Progressive knock-knees deformity (after age four to five years)

Persistent knock-knees (after age seven years)

Unilateral or asymmetric valgus deformity

Medial thrust* with ambulation

Short stature

History of metabolic disease, lower-extremity fracture, infection, tumor, or joint swelling/warmth

* A brief medial knee-joint protrusion during the stance phase of gait, which suggests incompetence of the knee ligaments.

Graphic 52012 Version 5.0

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