Knock Knees Correction Without Surgery
Posture (3) Genu valgum Note the presence of genu valgum, which is frequently associated with valgus flat foot. Genu valgum in turn is most commonly seen as a result of a growth disturbance about the knee, or as a complication of rheumatoid arthritis. pes planus is suspected, re-examine the sole for confirmatory evidence of callus under the metatarsal heads, and an increase in the area of the sole involved in weightbearing (i.e. extension of the narrow lateral strip). The footprint will be abnormal in these circumstances. Note also the presence of any knock-knee deformity.
Infants can occasionally be born with a dislocated patella. The patella is usually small and the knee is in valgus (knock-kneed). The tissues attaching to the outside of the patella are very tight, and the patella slips over the outer or lateral condyle of the femur while the baby is still in the uterus. Surgery is required to release these tight tissues and realign the patella. Older children can get habitual dislocation of the patella. The muscle and tendon attaching to the outside of the patella are again too tight, and in order to bend the knee, the patella has to slip over the lateral condyle. unless very mild, this also has to be treated surgically with release of the tight tissues. Recurrent dislocation or subluxation usually occurs in adolescents, girls more frequently than boys. This is different than habitual dislocation in cause and is generally less severe. Typically, these individuals have a larger-than-usual angle between the thigh and the patella tendon (called the Q...
Patellar osteoarthritis is characterized by tracer uptake at the lower or upper edge of the retro-patellar facet (Figs. 9.14 and 9.15). The narrowing of the patellofemoral joint and increased uptake in other articular compartments of the knee are important diagnostic features of os-teoarthritis. Due to altered locomotion, osteo-arthritis in genu valgum and genu varus tends to occur in the lateral and medial femorotibial compartment, respectively, whereas osteoar-thritis in flexion deformity is prone to affect the posterior compartment. As discussed below chondromalacia patellae is not osteoar-thritis in the strict sense, and, hence, usually not accompanied by osteoarthritis in other parts of the knee (Fig. 9.16).
Adequate exposure to sunlight and ingestion of dietary sources of vitamin D are typically sufficient to avoid a deficiency. Rickets, the failure of the bone to properly mineralize, is one type of vitamin D deficiency. The physical symptoms in infants and children include bow-shaped legs, knock knees, abnormal curvature of the spine and deformed thoracic and pelvic regions. In adults, the deficiency results in impaired calcium status. Phosphorus metabolism may also be impaired.2 Calcium interacts
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