Paediatric Conditions

Juvenile Bunions

Juvenile Bunions

Juvenile bunions, or juvenile hallux abductovalgus, are a type of foot deformity that affects the big toe joint of children or teenagers under the age of 18 years, where the big toe curves towards the lesser toes. The result of the deviation is a bony protrusion over the inner side of the big toe joint. The appearance of a juvenile bunion is similar to an adult bunion, with the only difference being the age of onset.

Juvenile bunions are considered a progressive deformity; therefore, it is expected that the big toe’s deviation worsens as a child grows up. Children affected by juvenile bunions will often not experience any discomfort in its early stages, however, as the deformity worsens, they will usually complain of pain and redness around the big toe joint.

Paediatric Flat Feet

Paediatric flat feet or pes planus is a condition whereby the child has a lowered or complete loss of arch along the inside of the foot, causing the feet and ankle to roll in towards to centre of the body. It is also widely known as “pronated feet” or someone with a “pronated gait”. Most parents with children suffering from flat feet would refer to their child’s gait as “walking with toes pointing out”, “walking like a duck”, or “foot slapping the ground”.

It is estimated that 2 to 3 in 10 children have flat feet, and this number is higher in Asian countries because joint hypermobility is more prevalent among Asians.

In-Toe Walking

In-toe Walking

In-toe walking, also known as “Pigeon toes”, is a condition whereby a child is walking with their toes pointing inwards and facing each other. This condition is considered a form of gait abnormality and is one of the common causes of frequent tripping and falling in young children. It is also one of the most common paediatric conditions that parents often neglect even after noticing the problem.

Toe Walking

Toe Walking

Toe walking, commonly referred to as “walking on tippy toes” by parents, is a condition to describe children who walk without heels touching the ground. Toe walking is a form of gait disorder and is associated with several underlying neurological or muscular conditions, such as cerebral palsy, muscular dystrophy, and autism. If left untreated, toe walking can lead to other injuries and conditions to the lower limb.

Knock Knees Child

Knock Knees (Genu Valgum)

Knock knees, medically termed genu valgum, is a congenital structural abnormality that affects the angle of the knees. Parents often refer to knock knees as “X-shaped” legs, where the knees are touching one another whilst the feet are wide apart when standing. 

Knock knees are determined by either the angular difference between the thigh bone (femur) and the leg bone (tibia) through an x-ray or by measuring the gap between the ankles when someone is standing with their knees together.

If within the normal reference range and age, knock knees are part of the normal development of a child. Children are expected to have mild knock knees after the age of 2 years, and peak at the age of 4 years.

Paediatric Heel Pain

Paediatric Heel Pain (Sever’s Disease)

Sever’s disease or calcaneal apophysitis is a type of osteochondroses that causes heel pain in children between the age of 8 to 14 years. This condition occurs when the Achilles tendon (the tendon that attaches to the back of the heel) pulls on the growth plate of the heel bone (calcaneal apophysis), resulting in swelling and inflammation of the growth plate.

Sever’s disease often occurs in active children and is more common in boys than girls. Children affected by Sever’s disease commonly complain of pain under the heel or at the back of the heel. In the early stages, the pain would normally occur only after high-impact activities or sports, but as the condition gets worse, the pain would eventually cause the child to limp even without activity.