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Bowlegs and Knock-Knees

By Simeon A. Boyadjiev Boyd, MD, Professor of Pediatrics and Genetics, Section of Genetics, Department of Genetics, University of California, Davis


In bowlegs, what doctors call genu varum, the legs appear curved out at the knees so that the knees are more widely separated than normal. This appearance is usually created by the position of the legs in the uterus before birth. This disorder is common among toddlers and usually resolves without treatment by the time the toddler is 18 months old. If bowlegs persists or becomes more severe, doctors need to rule out rickets or other metabolic bone diseases.

Doctors may also suspect Blount disease, which is caused by a problem with the growth plate in the shinbone (tibia). Blount disease can affect one or both legs. Most commonly, it appears after the first year of life. However, it can develop in adolescence in children who are overweight. Early diagnosis of Blount disease is difficult because the problem may not show up on x-rays. Early use of splints or leg braces can be effective in children under 3 years of age with Blount disease. Older children may be treated with surgery.


Knock-knees, what doctors call genu valgum, is less common than bowlegs. In knock-knees, the knees point inward. Even if severe, knock-knees usually resolves without treatment by the time the child is 9 years old. Children older than 10 years with severe knock-knees may need surgery.

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