Genu varum: a thin line between physiology and pathology: a case study

Abstract

Aim of the study: Genu varum (bow-legs), a typical developmental trait in children, often corrects naturally over time. However, distinguishing between normal and pathological genu varum is crucial to avoid misdiagnoses and unnecessary interventions, emphasizing the importance of understanding nuances in pediatric development for optimal child health care. Case description: The subject, aged 23 months at the time of initial consultation, presented with a noticeable deformity observed by his parents. Observed varus deformation was symmetrical. Lateral thrust was absent. Calculated tibial metaphyseal-diaphyseal (MD) angles are ~11° for both the right and left lower extremities. A femoral to tibial MD angle ratio >1 was established. Consequently, radiographic examinations reveal no traces of additional pathology. The predisposing factors contributing to the deformation are physiological processes attributable to normal growth paired with early onset walking. Current therapeutic intervention is confined to observational strategies. Sequential video documentation was carried out at 3, 9, and 12-month intervals post-diagnosis, with confirmation of varus regression. Conclusions: Conclusively, discerning physiological and pathological genu varum is vital to avoid misdiagnoses and unnecessary interventions in pediatrics. The study illustrates that normal growth and early onset of ability to walk can lead to physiological genu varum. Consequently, careful clinical and radiographic assessments, coupled with observational approaches, are sufficient for managing such cases, thus emphasizing a cautious and methodical strategy in pediatric care.