Article Sections

Introduction

Genu varum is a condition in which the knees angulate away from the midline, giving the appearance of bowlegs, whereas genu valgum occurs when the knees angulate toward the midline, giving the appearance of knock-knees.  These variations in lower extremity alignment are a transient part of physiologic development in children and must be differentiated from pathologic causes (eg, trauma, metabolic conditions) ( Figure 1).

Physiology

Lower extremity alignment proceeds through a predictable pattern of angulation in early childhood ( Figure 2).

  • In those age <2, alignment is characterized by physiologic genu varum (bowlegs), in which the knees angulate away from the midline. 
  • Angulation improves until around age 2, when alignment is neutral. 
  • From age 2-6, the knees angulate toward the midline, or physiologic genu valgum (knock-knees). 

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Figures

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