Which of the following stances is normal in a toddler?
A. Genu varum
B. Genu valgum
C. Lordosis
D. A and C
ANS: A
Observe a child's gait during well examination. Toddlers commonly walk with a wide-based gait and a bowlegged (genu varum) appearance. A knock-kneed (genu valgum) appearance is common in preschoolers. Assessment for scoliosis (a lateral curvature of the spine) should be performed at each well visit starting at age 10. With the child standing straight and arms at his or her side, observe for equal shoulder height. While the child bends forward, assess for curvature of the spine as well as rib humps. If abnormal findings are present, radiographs should be obtained for confirmation and to guide possible referral. Both the age of the child and the degree of the curve will guide treatment, if any. Scoliosis is more worrisome in a child who is prepubertal because there is more growth to occur and, therefore, more time for a curve to worsen.
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