Differential Diagnosis for a 2-year-old Girl with Inward Turning of the Right Leg and Bowing of the Leg

• Single most likely diagnosis:
  • Tibial Torsion: This condition is common in toddlers and is characterized by an inward twisting of the tibia, leading to an inward turning of the foot. It often corrects itself as the child grows.
• Other Likely diagnoses:
  • Femoral Anteversion: A condition where the femur (thigh bone) twists inward, causing the leg to turn inward. It's common in young children and often improves with age.
  • Genu Varum (Bowlegs): A condition where the legs curve outward, which can be a normal variation in toddlers but may also be due to other underlying conditions.
  • Metatarsus Adductus: A condition where the front part of the foot turns inward, which can be associated with tibial torsion.
• Do Not Miss diagnoses:
  • Neuromuscular Disorders (e.g., Cerebral Palsy): Conditions that affect muscle tone and movement, which can cause abnormal gait and leg positioning. Early diagnosis is crucial for intervention.
  • Infection or Osteomyelitis: Infections of the bone or joint can cause pain, swelling, and abnormal positioning of the leg. Prompt diagnosis and treatment are essential to prevent long-term damage.
  • Tumor or Cancer: Although rare, tumors can cause bone deformities or pain, leading to abnormal gait. Early detection is critical for effective treatment.
• Rare diagnoses:
  • Blount's Disease: A rare growth disorder of the tibia that causes the lower leg to angle inward, resembling a bowleg.
  • Rickets: A condition caused by vitamin D deficiency, leading to softening of the bones and potential deformities, including bowing of the legs.
  • Skeletal Dysplasias: A group of rare genetic disorders that affect bone growth and development, potentially leading to various skeletal abnormalities, including leg deformities.