Pediatric Intoeing

There are different causes for intoeing depending on where the legs or feet are misaligned:

• Curved foot (metatarsus adductus), which is usually present at birth
• Twisted shin (tibia torsion), the most common cause of intoeing, which occurs around age 1 to 3
• Twisted thighbone (femoral anteversion), which occurs around age 3 to 8 

The exact causes for these foot and leg problems are not certain, but medical experts suspect that it may be related to:

• Family history of intoeing
• Cramped position in the uterus 

Most children outgrow intoeing between ages 8 and 10. But your pediatrician may recommend testing if these symptoms continue or worsen:

• Feet shaped like crescent moons, mainly in infants
• Shins or thighbones that turn inward
• Limping, pain or swelling
• Problems with gait (way of walking) such as tripping or unusual clumsiness 

Your pediatrician may recommend further testing if he or she suspects that your child has intoeing, including:

• Physical examination of your child’s legs
• Diagnostic imaging, including CT scans, to evaluate the alignment of your child’s leg bones
• X-ray images or fluoroscopy (X-ray video) to observe your child’s leg bones in motion

Intoeing usually corrects itself without treatment in almost all children. However, your pediatrician may recommend treatment if your child develops severe problems. There are different options depending on the cause of the intoeing, including:

• Casts or corrective shoes for babies from 6 to 9 months old who have severely deformed or rigid feet
• Surgery to realign the shinbone or thigh bone in older children