Differential Diagnosis for Unilateral Intoeing in a 9-Year-Old
Single Most Likely Diagnosis
- Tibial Torsion: This is a common cause of intoeing in children, where the tibia (shin bone) twists inward. It's often seen in children around this age and can be unilateral.
Other Likely Diagnoses
- Femoral Torsion: Similar to tibial torsion, but the femur (thigh bone) is twisted inward. This condition can also cause intoeing and is more common in children.
- Metatarsus Adductus: A congenital condition where the foot is adducted (turned inward), which can cause intoeing. Although it's more common in infants, it can persist into childhood.
- Clubfoot (Talipes Equinovarus): A congenital deformity of the foot that can cause intoeing, although it's typically identified at birth.
Do Not Miss Diagnoses
- Neurological Conditions (e.g., Cerebral Palsy, Neuromuscular Diseases): Although less common, neurological conditions can cause intoeing due to muscle imbalances or spasticity. Missing these diagnoses could lead to delayed treatment and significant long-term consequences.
- Tumors (e.g., Osteoid Osteoma, Neurofibroma): Rarely, intoeing can be a presenting symptom of a tumor affecting the bone or nerve. Early detection is crucial for effective treatment.
Rare Diagnoses
- Slipped Capital Femoral Epiphysis (SCFE): A rare condition where the growth plate in the femur slips out of place, which can cause intoeing among other symptoms. It's more common in obese or rapidly growing children.
- Legg-Calve-Perthes Disease: A rare condition where the blood supply to the femoral head is disrupted, leading to necrosis and potential intoeing. It typically affects children between 4-10 years old.