This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) highlights the case of an 8-year-old boy who presents with a 3-month history of in-toeing. Anteroposterior pelvic and bilateral frog-leg radiographs are included, along with measurements of the foot progression angle, medial rotation of the hip, and the thigh-foot axis.
The Image Quiz reviews the natural history of lower-extremity rotational deformities in children, and describes in detail how to make the physical-examination measurements that helped answer the clinical question of whether this patient’s in-toeing was benign or a sign of a more serious deformity.
In toeing could be a sign of a proggressive deformity.
8 years old can be early sign of perthes disease pt may need MRI to show early head necrosis
Excessive anti version of the femoral neck is the starting point of this problem