The JBJS Quiz of the Month is a collection of 10 relevant questions from each orthopaedic subspecialty. The questions are drawn from JBJS Clinical Classroom, which houses over 4,500 questions and 3,100 learning resources. Take the Quiz to see how you score against your peers!

NOTE: This quiz does not earn users CME credits. The questions must be answered within Clinical Classroom to earn CME credits.

A 3-year-old boy has intoeing and trips frequently while walking. He tends to sleep in a fetal position on his stomach. His hip internal rotation is 45° and external rotation is 45°. The thigh-foot angle is minus 20° (inwards) and the heel bisector line crosses at the 2nd toe. Which of the following is most likely the cause of his intoeing?
    • Femoral anteversion
    • Internal hip rotation greater than external rotation or a palpated greater trochanteric angle of >15° would indicate this.
    • Internal tibial torsion
    • The thigh-foot angle confirms the deformity to be in the tibia. A bimalleolar axis would also confirm this.
    • Metatarsus adductus
    • The heel bisector going through the lesser rays lateral to the 2nd toe would indicate this.
    • External tibial torsion
    • A positive thigh-foot angle or bimalleolar angle of >15° or 25°, respectively, would indicate this.