EpistemisGenu valgus or varus of progressive establishment
Specialty: Musculoskeletal.
Why it occurs
- Advanced asymmetric unicompartmental osteoarthritis of the knee (external compartment in genu valgus, internal compartment in genu varus)
- Paget's disease of bone with deformity of the femur or tibia
- Osteomalacia or rickets in adults due to severe vitamin D deficiency
- Destructive rheumatoid arthritis with collapse of the lateral tibial plateau
- Sequela of knee joint fracture consolidated in malposition (malunion of tibial plateau)
- Avascular necrosis of the internal femoral condyle
Initial workup
Telemetry of lower limbs in weight bearing (panoramic radiography of complete legs to trace the femoro-tibial mechanical axis) | Magnetic resonance imaging of the knee (evaluates the status of the joint compartments, collateral ligaments and meniscus integrity) | General analysis to assess calcium metabolism (calcium, phosphorus, alkaline phosphatase, 25-OH-vitamin D).
red flags
Valgus or varus knee deformity that progresses rapidly in a few months associated with intractable nocturnal bone pain and a palpable mass in the distal femur or proximal tibia (suspected osteosarcoma or chondrosarcoma).
Standard management
- There are no drugs to correct deviations of the anatomical bone axis — requires corrective osteotomy or arthroplasty); for symptomatic relief of the overloaded compartment: Chondroitin sulfate (800 mg daily orally
- Meloxicam — 15 mg per day orally during pain attacks due to mechanical overload
- Glucosamine sulfate (1500 mg once a day).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Musculoskeletal
- Listed causes
- 6
- Treatment options
- 3