Bow legs and knock knees: is it physiological or pathological?

Ramagopal, Ganavi

doi:10.18203/2349-3291.ijcp20161068

Cited by 6 publications

(5 citation statements)

References 1 publication

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“…However, if it is not behaving in this manner it is important to look into other causes of hyperphosphatasemia such as rickets, hepatic dysfunctions and chronic kidney disease. Bow legs is very common under 2 years of age and it is a normal physiological phenomenon in most occasions (5) .…”

Section: Discussionmentioning

confidence: 99%

A case of transient hyperphosphatasemia presenting with mild degree of bow legs

Kankananarachchi

Athukorala

2021

Sri Lanka J. Diabetes Endocrinol. Metab.

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Introduction: Transient Hyperphosphatasia (TH) is a benign condition in which serum Alkaline Phosphatase is elevated without any underlying pathology. This is mainly seen in children compared to adults and it is usually an incidental finding. The hallmark of the condition is that normalization of ALP level will with time. However, not knowing the entity would lead to unnecessary investigations and referrals. Here we report a child with TH who presents with a mild degree of bow legs.Case report: A 1year and 8 months old boy was brought by his mother with a concern of bow legs. He was the first child born to non-consanguineous healthy parents following normal antenatal and perinatal periods. His birth weight was 3.5kg and he was growing in his birth centile. He had age-appropriate development and parents had been having a concern about bow legs after he started walking. He is getting an average Sri Lankan diet with animal food and he gets adequate sun exposure as well. There was no history to suggest the liver of renal diseases.On examination, he had a mild degree of bow legs without any features to suggest rickets. His cardiovascular, respiratory, abdominal, and neurology exams were normal.His bone profile showed a high value of ALP (3782 U/L) with normal calcium, phosphate, and vitamin D levels. Due to high ALP levels, he underwent liver and renal functions and that was within the normal range.The diagnosis was made as TH and he was followed up monthly with ALP values. He had a downward trend of ALP levels and in 3 months the ALP value dropped to (580 U/L). Parents were reassured about the condition and the diagnosis was confirmed as TH. Conclusion:It is important to rule out, bone, kidney, or a liver pathology if a child has markedly elevated ALP levels. However, it is important to recognize this entity to avoid unnecessary procedures and concerns.

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Section: Discussionmentioning

confidence: 99%

A case of transient hyperphosphatasemia presenting with mild degree of bow legs

Kankananarachchi

Athukorala

2021

Sri Lanka J. Diabetes Endocrinol. Metab.

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“…The tibiofemoral angle can be expressed indirectly by measuring the intermalleolar distance first, defined as the distance between the medial malleoli of the distal tibiae while the patient touches their medial femoral condyles together (Baruah, Kumar, & Harikrishnan, 2017). Intercondylar distance is a measurement used to indicate the degree of genu varum, defined as the distance between the medial femoral condyles when medial tibial malleoli are touching (Ganavi, 2016). Measuring techniques include photographic, clinical measurements, radiographic and CT scanning (Ganavi, 2016).…”

Section: Measuring Genu Valgum In Living Populationsmentioning

confidence: 99%

“…Intercondylar distance is a measurement used to indicate the degree of genu varum, defined as the distance between the medial femoral condyles when medial tibial malleoli are touching (Ganavi, 2016). Measuring techniques include photographic, clinical measurements, radiographic and CT scanning (Ganavi, 2016). Regardless of the measurement or technique used, knee angles are generally measurable with a precision of only 1° (Oginni, Badru, Sharp, Davie, & Worsfold, 2004).…”

Section: Introductionmentioning

confidence: 99%

Knock‐knees: Identifying genu valgum and understanding its relationship to vitamin D deficiency in 18th to 19th century northern England

Tschinkel

Gowland

2020

Intl J of Osteoarchaeology

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Genu valgum is a condition in which a person's knees angle inwards and touch one another creating a "knock-kneed" appearance during life and potentially causing pain and walking difficulties. The most common cause of genu valgum is medial torsion of the proximal tibia, such that the lateral side becomes more weight bearing. It is considered a feature of vitamin D deficiency and many other pathological conditions. Currently, bioarchaeologists lack clear diagnostic criteria to identify genu valgum in skeletal remains, and it is therefore likely to be underreported. The aim of this study was to develop a method for diagnosing genu valgum and apply it to the analysis of adult skeletons from two 18th to 19th century skeletal collections from the North of England. Six individuals from Coach Lane and three from Fewston showed evidence of genu valgum. All of these individuals had other skeletal indicators of vitamin D deficiency. We discuss the relationship between vitamin D deficiency and genu valgum alongside other possible etiologies identified in the clinical literature. The individuals who presented with vitamin D deficiency related genu valgum in this study were diagnosed with adolescent rickets. Individuals who were vitamin D deficient in early childhood were more likely to be vitamin D deficient later in life and exhibit more advanced genu valgum. Genu valgum is often overlooked in the palaeopathological literature but its presence may be an important indicator of broader health problems.

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“…A distance of up to 6cm is considered as a normal value. [11] In Football, the knee joint sustains an inordinate amount of load and torque, particularly when sustained at a higher level of competition. High amount of stress and strain imposed on a joint during growth and adolescence through intensive practice of a sport may contribute to a growth deformity.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Dynamic Balance in Football Players with and without Genu Varum Using Star Excursion Balance Test

Shah¹,

Palkar²

2021

Int J Health Sci Res

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Background and Aims: Genu Varum is an angular deformity of the knee that is responsible for the alteration of the forces at the knee so that the line of force shifts farther medially from the knee joint centre intensifying the medial compartment load and creating a medial joint reaction force that is nearly three and a half times that of the lateral compartment. Football is a high intensity sport that places inordinate amounts of load and torque on the knee joint making it more susceptible to growth deformities in the developing age groups. Genu varum is a predisposing factor to lateral instability which affects dynamic balance. This study consists of a comparison in dynamic balance between professional football players, those without a knee deformity and those with genu varum deformity using the Star excursion balance test. Methodology: A comparative study was conducted among 40 elite level football players and they were divided into two groups one of which consisted football players without a knee deformity and the other group which comprised of football players with genu varum. Genu varum was calculated using the intercondylar distance measure. Star excursion balance test was used to assess dynamic balance of each individual and their average distances were calculated for each direction in the test. Results: The Reach Distances in the anterior direction showed no significant difference (P>0.05) between the control and Group Bs whereas significant differences (P<0.05) were obtained in the Posteromedial and Posterolateral directions. Conclusion: There was no significant difference in reach distances in the anterior direction but significant differences in the reach distances were observed in the posteromedial as well as the posterolateral direction suggesting that genu varum deformity does affect the dynamic balance in elite level football players. Key words: Genu Varum, Football Players, Dynamic Balance, Star excursion balance test.

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Bow legs and knock knees: is it physiological or pathological?

Cited by 6 publications

References 1 publication

A case of transient hyperphosphatasemia presenting with mild degree of bow legs

A case of transient hyperphosphatasemia presenting with mild degree of bow legs

Knock‐knees: Identifying genu valgum and understanding its relationship to vitamin D deficiency in 18th to 19th century northern England

Comparison of Dynamic Balance in Football Players with and without Genu Varum Using Star Excursion Balance Test

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