RT Journal Article SR Electronic T1 Prevalence of musculoskeletal normal variations of the lower limbs in pediatric orthopedic clinic JF Saudi Medical Journal JO Saudi Med J FD Prince Sultan Military Medical City SP 930 OP 935 DO 10.15537/smj.2019.9.24478 VO 40 IS 9 A1 Safwan M. Bourgleh A1 Răducu N. Nemeş A1 Bandar M. Hetaimish A1 Luminița C. Chiuțu YR 2019 UL http://smj.org.sa/content/40/9/930.abstract AB Objectives: To determine the rate of pediatric orthopedic clinic visits attributable to normal musculoskeletal (MSK) variations in children less than 12 years of age; to characterize the etiology and to characterize the etiology and management plan in this group in an attempt to identify areas that could be improved in pediatric orthopedic clinical practice.Methods: The study was a retrospective evaluation of 2,321 consecutive patients who visited a private pediatric orthopedic specialty clinic in Jeddah, Saudi Arabia between 2011-2016. All consultations were recorded in accordance with the standard protocol via data record form.Results: We identified 764 (32.9%) patients with normal variation of the lower limbs, age birth to 12 years old. No significant association between gender and normal variation was noticed. The following types of normal variation were registered: 189 (24.7 %) genu varus or valgus, 257 (33.6%) in-toe gait, and 318 (41.6%) flexible flat foot. Seven hundred and thirty-seven (96.5%) cases were normal variations, while only 27 cases (3.5%) were deemed pathological and required further treatment.Conclusion: Normal variations represent the most common complaint in pediatric orthopedic private practice. Inappropriate referrals, useless follow-up visits, and excessive investigations were a common practice, overloading the health care system. None of the previous efforts made any notable improvement.