There are two types of pediatric knee deformities: genu varum (bowlegs) and genu valgum (knock-knees).

If a child stands straight with their feet together but their knees do not touch, they have bow-legs. If a child’s knees touch but ankles do not while standing straight, they have knock-knees.

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What are the signs and symptoms of genu varum and/or genu valgum??

While these conditions do have overlap, they have different signs and symptoms:


  • While standing straight, ankles touch or are close together while knees are apart
  • Knees curved outwards in both legs
  • May cause awkward walking pattern
  • Toes may point inward (known as “intoeing” or “pigeon-toe”)
  • Clumsiness or frequent tripping


  • While standing, knees touch or are close together while ankles are apart
  • Knees angle inward in both legs
  • Unusual walking pattern
  • Outward rotated feet

Please note that these conditions usually do not bother young children. Genu varum and genu valgum should not cause pain or discomfort. If your child does experience pain, they may need further evaluation.

What causes genu varum or genu valgum?

There are physiologic and pathologic causes for genu varum and genu valgum:


  • Part of normal growth and development (no known cause)


  • Rickets disease
  • Blount’s disease
  • Skeletal dysplasia

How are genu varum and/or genu valgum diagnosed?

  • Physical exam

How are genu varum and/or genu valgum treated?

Genu varum and genu valgum usually resolve on their own. Normal growth and development over time may correct bowlegs and knock-knees.

In some instances, your child may need further evaluation and testing:

  • If the condition causes pain or discomfort
  • If the condition worsens after age 2
  • If the condition does not resolve itself by early adolescence

Your child’s doctor at Connecticut Children’s can assess if further testing is needed.

Doctors at Connecticut Children’s offer state-of-the-art limb lengthening and limb modification technologies, such as Ilizarov frames or the Precice nail. Additionally, Connecticut Children’s has a world-class motion analysis lab to diagnose complex walking abnormalities.