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A case of physiological genu vulgum with 5 months follow up with long standing AP X ray film

I share with you a 3 years old case of genu vulgum that is improving on 5 months follow up. 
Tibio-femoral angle was 17 and 14 for right and left sides respectively. After 5 months it is about  12 and 10 for right and left sided respectively.

Bilateral Genu vulgum is a physiological process between 3 and 4 years up-to 22 degrees. After 7 years genu vulgum should not exceed 12 degrees. Surgery is indicated if vulgus angle is more than 15-20 degrees after 10 years. 

In most cases, physiological genu vulgum (knock knees) don't need to be treated because it usually correct itself as your  child grows. The child doesn't need to avoid his activity, wear supportive leg braces or shoes, or do any special exercises. However, exercise can help realign and stabilize knees and strengthen  muscles.

Causes of pathological genu vulgum:
physeal damage or overgrowth, congenital anomalies, skeletal dysplasias, some genetic disorders, metabolic disorders, and rheumatologic diseases.