| Referring diagnosis | Suggested work-up and initial management | When to refer |
|---|---|---|
| Back pain | X-ray Normal X-rays - course of therapy or further work-up |
Abnormal findings |
| Scoliosis | X-ray | Curve greater than 10 degrees |
| Leg length discrepancy | X-ray | Discrepancy greater than 2cm |
| Bowlegs/Genu varum | X-ray no earlier than 2 years of age | Abnormal findings |
| Intoeing Internal tibial torsion Femoral anteversion |
Observation until 4 years of age Observation until 10 years of age |
Unable to perform daily activities |
| Limping (acute) | X-Ray, lab (CBC, ESR, CRP) | Once studies are completed |
| Abnormal gait / toe walking / dragging of extremity / limping (chronic) |
Must send for Neurology evaluation | Once Neurology evaluation is completed |
