![]() Most children who present with lower extremity problems have normal rotational and angular findings (i.e., within two standard deviations of the mean). A history and physical examination that include torsional profile tests and angular measurements are usually sufficient to evaluate patients with lower extremity abnormalities. With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid. Angular problems include genu varum (bowleg) and genu valgum (knock knee). Out-toeing is caused by external tibial torsion and femoral retroversion. ![]() Out-toeing is less common than intoeing and occurs more often in older children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Intoeing is most common in infants and young children. Rotational problems include intoeing and out-toeing. ![]() Leg and foot problems in childhood are common causes of parental concern.
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