Genu valgum is a deformation of the knee joint Knee joint The knee joint is made up of the articulations between the femur, tibia, and patella bones, and is one of the largest and most complex joints of the human body. The knee is classified as a synovial hinge joint, which primarily allows for flexion and extension with a more limited degree of translation and rotation. Knee Joint: Anatomy(s) that creates angulation Angulation Buckle or Torus Fracture of the lower limb(s) toward the midline in the coronal Coronal Computed Tomography (CT) plane. Children ages 1–5 years are commonly affected. Many cases of genu valgum are physiologic and will resolve with further growth. However, it is critical to differentiate between normal physiologic changes and pathologic disorders, as pathologic cases can have serious long-term consequences if not corrected. Clinical presentation Presentation The position or orientation of the fetus at near term or during obstetric labor, determined by its relation to the spine of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the neck. Normal and Abnormal Labor includes characteristic inward bowing of the lower limbs accompanied by gait Gait Manner or style of walking. Neurological Examination disturbances. Diagnosis is clinical but may require support with diagnostic imaging. Management is often supportive but may require surgical intervention.
Last updated: 1 Jul, 2021
Genu varum Genu varum Genu varum is a deformation of the knee joint(s) that creates angulation of the lower limb(s) away from the midline in the coronal plane. Children ages 1-5 years are commonly affected. Genu Varum and genu valgum: note the difference in angulation Angulation Buckle or Torus Fracture in the coronal Coronal Computed Tomography (CT) plane.
Image by Lecturio. License: CC BY-NC-SA 4.0Bilateral genu valgum:
Unilateral genu valgum:
Pathologic genu valgum:
This child with
rickets
Rickets
Disorders caused by interruption of bone mineralization manifesting as osteomalacia in adults and characteristic deformities in infancy and childhood due to disturbances in normal bone formation. The mineralization process may be interrupted by disruption of vitamin d; phosphorus; or calcium homeostasis, resulting from dietary deficiencies, or acquired, or inherited metabolic, or hormonal disturbances.
Osteomalacia and Rickets has developed genu valgum, most notably in the right knee.
Diagnosis is primary based on clinical examination. It is critical to differentiate between normal physiologic genu valgum and a pathologic process.
X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests:
X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests of a child with genu valgum
Image: “ Mutation Mutation Genetic mutations are errors in DNA that can cause protein misfolding and dysfunction. There are various types of mutations, including chromosomal, point, frameshift, and expansion mutations. Types of Mutations study for a six-year-old girl with genu valgum” by Kaustuv Bhattacharya, et al AL Amyloidosis. License: CC BY 4.0, cropped by Lecturio.The majority of cases of genu valgum are physiologic and should resolve spontaneously; thus, they require only observation and expectant management.
Observation:
1st-line treatment, appropriate if:
Medical management:
Reduction in genu valgum:
Improved valgus
deformity
Deformity
Examination of the Upper Limbs in a 9-year-old child with
rickets
Rickets
Disorders caused by interruption of bone mineralization manifesting as osteomalacia in adults and characteristic deformities in infancy and childhood due to disturbances in normal bone formation. The mineralization process may be interrupted by disruption of vitamin d; phosphorus; or calcium homeostasis, resulting from dietary deficiencies, or acquired, or inherited metabolic, or hormonal disturbances.
Osteomalacia and Rickets at 1-year follow-up after
vitamin D
Vitamin D
A vitamin that includes both cholecalciferols and ergocalciferols, which have the common effect of preventing or curing rickets in animals. It can also be viewed as a hormone since it can be formed in skin by action of ultraviolet rays upon the precursors, 7-dehydrocholesterol and ergosterol, and acts on vitamin D receptors to regulate calcium in opposition to parathyroid hormone.
Fat-soluble Vitamins and their Deficiencies therapy.