A 15-Month-Old Boy Is Brought to the Office for Evaluation

A 15-month-old boy is brought to the office for evaluation of bowed legs.  The boy's mother says that his legs have always been slightly bowed, but the bowing appears to have worsened since he started walking a month ago.  The patient does not appear to be in pain and is still able to play outside.  He eats a varied diet and drinks 16 ounces of whole milk a day.  He is an only child and was born at full term via vaginal delivery with no complications.  The patient is at the 40th percentile for height and the 25th percentile for weight.  On examination, he has full range of motion of bilateral hips and knee and ankle joints.  The legs are of equal length and have no joint effusions.  When the boy stands with his feet together, there is a tibiofemoral outward bend that results in a gap between the knees.  The remainder of the examination is unremarkable.  Which of the following is the best next step in management of this patient?

A) Bilateral leg x-rays
B) Leg orthotics and physical therapy
C) Reassurance and observation
D) Surgical correction
E) Vitamin D and calcium supplementation

Correct Answer:

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