Paediatric orthopaedics: lower limb alignment: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: lower limb alignment

Sample item

An 18-month-old walking toddler has symmetrical bowing of both legs and is otherwise well, with normal height and no family history of rickets. What is the appropriate management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Reassure the parents, because this is physiological genu varum that usually resolves by 2 to 3 years

Physiological genu varum is common in toddlers, symmetrical, mild and improving, and resolves by 2 to 3 years, often followed by a phase of knock knees. Features that suggest pathology are asymmetry, progression, short stature, onset after 2 years, a localised proximal tibial deformity (Blount disease) or rickets, and these need investigation.

Option by option

  • A. Start high-dose vitamin D injections

    Vitamin D injections are not indicated without evidence of rickets.

  • B. Reassure the parents, because this is physiological genu varum that usually resolves by 2 to 3 years (correct)

    Correct. Symmetrical bowing in a well toddler is usually physiological and resolves with growth.

  • C. Corrective osteotomy

    Osteotomy is for persistent pathological deformity in older children.

  • D. Immediate bracing

    Bracing is not needed for physiological bowing.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is B, Reassure the parents, because this is physiological genu varum that usually resolves by 2 to 3 years. Physiological genu varum is common in toddlers, symmetrical, mild and improving, and resolves by 2 to 3 years, often followed by a phase of knock knees.

Why is "Start high-dose vitamin D injections" not the answer?

Vitamin D injections are not indicated without evidence of rickets.

Why is "Corrective osteotomy" not the answer?

Osteotomy is for persistent pathological deformity in older children.

Why is "Immediate bracing" not the answer?

Bracing is not needed for physiological bowing.

What concept does this question test?

It tests Paediatric orthopaedics: lower limb alignment in Orthopaedics. Features that suggest pathology are asymmetry, progression, short stature, onset after 2 years, a localised proximal tibial deformity (Blount disease) or rickets, and these need investigation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: lower limb alignment?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.