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Addressing pediatric intoeing in primary care

doi: 10.1097/01.NPR.0000541504.71521.4d
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INSTRUCTIONS Addressing pediatric intoeing in primary care


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Addressing pediatric intoeing in primary care

Purpose: To provide information regarding differential diagnosis and treatment for pediatric intoeing. Learning Objectives Outcomes: After completing this continuing education activity, you should be able to: 1. Outline the physical exam for a child with intoeing. 2. Summarize differential diagnoses for intoeing. 3. Identify treatment for intoeing.

  1. Intoeing usually requires
    1. intense treatment.
    2. moderate therapy.
    3. no intervention.
  2. Research demonstrates that most children with intoeing should be managed by a
    1. primary care provider.
    2. orthopedist.
    3. physical therapist.
  3. Which of the following should guide intoeing management?
    1. radiographic studies
    2. history and physical
    3. parental concern
  4. When does lower extremity alignment begin?
    1. intrauterine
    2. birth to 1 year
    3. 1 to 3 years
  5. Metatarsus adductus is characterized by deviation in which direction?
    1. lateral
    2. medial
    3. inferior
  6. Metatarsus adductus is usually
    1. unilateral.
    2. bilateral.
    3. contralateral.
  7. Internal tibial torsion is internal rotation of the tibia along its
    1. medial axis.
    2. short axis.
    3. long axis.
  8. Up to how many degrees of femoral anteversion is normal at birth?
    1. 20 degrees
    2. 40 degrees
    3. 60 degrees
  9. A family history of intoeing should most likely lead to
    1. genetic testing.
    2. surgical correction.
    3. parental reassurance.
  10. It is best to assess for intoeing while children are
    1. supine, sitting, and standing.
    2. sitting, standing, and walking.
    3. standing, walking, and running.
  11. Increased distance between the knees when standing and a waddling gate are signs of
    1. bowleg.
    2. intoeing.
    3. hip dysplasia.
  12. Care for genu varum in a 2-year-old child most likely would include
    1. casting.
    2. monitoring.
    3. bracing.
  13. Which of the following may be suggested for metatarsus adductus?
    1. splints
    2. orthotics
    3. massages
  14. Children with femoral anteversion should sit in
    1. a comfortable position.
    2. an erect position.
    3. a cross-legged position.
  15. Educate patients' families on
    1. intoeing prevalence.
    2. increased risk of hip arthritis.
    3. activity restriction.
  16. Regarding children with intoeing and participation in school activities, explain to the families that children should engage in
    1. activities once intoeing starts to resolve.
    2. low-impact activities.
    3. all activities anytime.
  17. Which of the following in an 8-year-old child would indicate the need for an orthopedic referral?
    1. 20 degrees of femoral anteversion
    2. unilateral intoeing
    3. medial deviation of the metatarsals
  18. Which of the following would most likely require treatment?
    1. internal tibial torsion
    2. history of sibling intoeing
    3. limping


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