Blount's disease

What is Blount's Disease?

Blount's disease is a growth disorder that affects the shin bone (tibia) in children, causing it to grow abnormally and resulting in a bowlegged appearance [11][12]. This condition occurs when there is an abnormality in the growth plate of the upper part of the tibia, leading to an inward curvature of the lower leg [13].

Characteristics of Blount's Disease

The main characteristic of Blount's disease is the bowing of the legs, which can be mild or severe. In some cases, the condition may also cause pain and discomfort in the affected leg [14]. The disease typically affects children between the ages of 3 and 14 years old, with most cases occurring before the age of 10 [15].

Symptoms of Blount's Disease

The symptoms of Blount's disease include:

• Bowlegged appearance
• Pain or discomfort in the affected leg
• Limited mobility or stiffness in the knee joint
• Abnormal growth patterns in the shin bone

Treatment Options for Blount's Disease

Treatment options for Blount's disease typically involve bracing, casting, or surgery to correct the abnormal growth pattern and straighten the legs [14]. In some cases, physical therapy may also be recommended to improve mobility and strength in the affected leg.

Note: The information provided is based on the search results and context provided.

Symptoms of Blount's Disease

Blount's disease is a disorder that affects the growth plates in the bones around the knee, causing a child to have a bowlegged appearance. The most common symptom of bowed legs is an awkward walking pattern.

• Bowing of one or both legs: This is the most noticeable sign of Blount's disease, where the legs appear bent outward even when the ankles are together.
• Trouble walking: Children with Blount's disease may experience difficulty walking due to the abnormal curvature of their legs.
• Possible knee pain: Some children may experience knee pain or discomfort as a result of the condition.

Other associated symptoms

• Obesity and early puberty: Blount's disease is more common among African American children, and it has been linked to obesity and early puberty.
• Abnormal growth plates: The shinbone (tibia) in one or both legs grows abnormally, causing a sharp curve below the knees.

Important notes

• Toddlers with bowed legs usually have normal coordination and are not delayed in learning to walk. However, as they grow older, the condition can become more pronounced.
• Blount's disease can lead to future problems with walking if left untreated.

References: [2] [3] [4] [5] [8]

Blount's disease diagnosis involves a combination of physical examination and imaging tests to confirm the condition.

Imaging Tests

• X-rays of the legs, particularly in the standing position, can show signs of Blount's disease or rickets [1].
• An x-ray of the knee and lower leg confirms the diagnosis [5].
• In some cases, a magnetic resonance imaging (MRI) test may be ordered to further evaluate the condition [3].

Physical Examination

• A comprehensive physical exam by an orthopedist is essential in diagnosing Blount's disease [1].
• The doctor will perform a careful physical examination to identify signs of the condition [7].

The diagnostic procedures for Blount's disease typically involve a clinical assessment and the use of X-rays (full length, AP, and lateral) [9].

Based on the provided context, it appears that there are various treatment options for Blount's disease, including both non-operative and operative methods.

Non-operative Treatment

• Bracing is a common non-operative treatment option, particularly in mild cases below the age of 3. This method involves using braces to unload the overloaded inner side of the knee (see [6] and [7]). However, bracing may take up to 2 years and can be cumbersome.
• In some instances, nonoperative treatment is an option for patients with infantile (early-onset) Blount disease, especially if diagnosed before age 4 years. Knee-ankle-foot orthoses (KAFOs) have a role in Langenskiöld stage I or II disease, particularly with unilateral involvement (see [7]).

Operative Treatment

• Surgery may be necessary in cases of failed brace treatment or for more severe cases of Blount's disease.
• The operative treatment options include various surgical interventions such as guided growth, acute correction, gradual correction, hemi-plateau elevation, double elevating osteotomy, and physeal (see [8]).

It is essential to note that the specific treatment approach depends on the age and severity of the condition at presentation. A thorough evaluation by a pediatric orthopedist is necessary to determine the best course of treatment for each individual case.

References: [6] July 1, 2021 - Each child's brace is designed ... [7] September 12, 2023 - Nonoperative treatment is an option in a select group of patients with infantile (early-onset) Blount disease (tibia vara). [8] August 5, 2021 - A diagnosis of Blount’s disease is based on a thorough patient history, physical examination and a standing-alignment X-ray...

Differential Diagnosis of Blount's Disease

Blount's disease, also known as tibia vara, is a growth disorder that affects the shin bone (tibia) in children and adolescents. The differential diagnosis for Blount's disease includes several conditions that can cause similar symptoms.

• Physiologic bowing: This is a normal variation of the lower leg where the tibia bows outward, but it does not progress beyond 10-15 degrees [1].
• Congenital bowing: This is a rare condition where the tibia is bowed at birth and can be associated with other skeletal abnormalities [2].
• Rickets: A disease caused by vitamin D deficiency that can lead to softening of bones, including the tibia, resulting in bowing or deformity [3].
• Ollier disease: A rare genetic disorder characterized by abnormal growth of bone tissue, which can cause bowing or deformity of the tibia [4].
• Trauma-related deformities: Injuries to the proximal tibial metaphysis can lead to bowing or deformity of the tibia [5].

Key Points

• Blount's disease is a distinct entity from other conditions that cause lower leg deformity.
• A thorough medical history and physical examination are essential for diagnosing Blount's disease.
• Radiographic evaluation, including measurement of the tibial metaphyseal-diaphyseal angle, can help distinguish Blount's disease from other conditions [6].

References

[1] Context 1 [2] Context 4 [3] Context 7 [4] Context 9 [5] Context 3 [6] Context 2