Pediatric Ankle Valgus Clinical Presentation

Updated: Nov 14, 2019
  • Author: Peter M Stevens, MD; Chief Editor: Jeffrey D Thomson, MD  more...
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Presentation

History and Physical Examination

In the standing position, the medial malleolus is unduly prominent, and the heel and hindfoot are angled laterally, relative to the calf (see the image below). A common finding is subfibular tenderness due to impingement. There may be concomitant hindfoot deformity, more commonly planovalgus than cavovarus.

One needs to differentiate between ankle valgus (s One needs to differentiate between ankle valgus (shown here) and hindfoot valgus. It is imperative to obtain a standing anteroposterior radiograph of the ankle when evaluating foot problems.

Proximally, there may be concomitant genu valgum with a corresponding increase in the intermalleolar distance (see the image below). When the etiology is neuromuscular, the patient may have muscle weakness, imbalance, or contractures.

Patients may have valgus at more than just the hin Patients may have valgus at more than just the hindfoot and ankle. This boy with congenital clubfeet has genu valgum compounding his gait problems.