New Born and Children Anomaly Screening Programs

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Orthopaedic Anomaly Screening Program

SAC : Screening for Anomalies in Children

Essential for Common and Challenging Orthopaedic problems.

Presenting complaints, etiology and genetics enquiry should be obtained

Step-by-Step orderly clinical examination of the part and the child.

Sympathy, Kindness, Patience and Concern are key elements. Also considered are the wants and needs of the child and his parents.


a. Inspection (in stance and posture) and gait. Alignment, length & torsion.

b. Palpation     i. Assessment of Deformities esp. Length discrepancy

ii. Range of Motion of joints ROM

iii. Testing of Muscle Power & Strength

iv. Neurological status examination


These are necessary to make a definitive diagnosis but a reasonable assessment could be done with clinical examination and ultrasound evaluation, though radiography takes the assessment to a higher level.

a. Radiography controlled views and with low dose radiation

b. Ultrasound examination

c. CT Low Dose rarely required

d. MRI with sedation control.

Laboratory Tests (Bone Profile)

CBC with ESR

Serum Calcium

Serum Phosporus,

Serum Alkaline Phosphatase




New Born Evaluation 

3rd month screening

6th month screening

1 year screening

Foot and Ankle


Half length of foot                 Full length of foot       Skeletal Maturity

Girls                          1 year                                           12 years                            12 years

Boys                          1.5 years                                      16 years                             14 years

Postural and Congenital Deformities of Foot and Ankle

Intrauterine Malposture

Congenital malformation


Postural deformities of the new born are Metatarsus Primus Varus, Metatarsus Adductus, Postural Clubfoot, Pes Equinus & Valgus, Calcaneovalgus.  Examine the whole body for other possible posture deformities.

Congenital deformities that cause Intoeing (Toeing-in) are Congenital Hallux Varus, Congenital Metatarsus Varus, Congenital talipesequinovarus CTEV, Ankle Varus due to short tibia.

Outoeing(Toeing-out) could be due to Calcaneovalgus, Pes Valgus-postural, Congenital Vertical Talus,


Footprint test, Plumbline Test, Toe-raising Test, Standing Radiography,

Tarsal coalition 

Congenital tarsal coalition is seen on plain radiography.

Pes Cavus

It is a manifestation of neuromuscular affection with dynamic imbalance of muscles of the foot or the body.

Congenital Vertical Talus

This uncommon birth deformity is rigid and often missed until later in infancy or still when the child begins to stand and walk. The foot is flat and has a an odd shape. The toes out and shoe doesn’t fit in well.

Orthopedic Surgeon could reassure for most of the deformities, complete and serial reviews are desirable.