. Doctor Examination
Parents are usually the first to detect a leg length discrepancy when they notice a problem with the way their child walks. Discrepancies are also sometimes detected when a child undergoes a screening at school for curvature of the spine (scoliosis). It is important to note, however, that leg length discrepancy does not cause scoliosis.
Your doctor will conduct a thorough physical examination and use tests to confirm or diagnosis a discrepancy in length.
. Physical Examination
During the exam, your doctor will ask about your child's general health, medical history, and symptoms. He or she will then perform a careful examination, observing how your child sits, stands, and moves.
. Gait analysis. During the examination, your doctor will closely observe your child's gait (the way he or she walks). Young children may compensate for a limb length discrepancy by flexing their knee or walking on their toes.
. Measuring the discrepancy. In most cases, the doctor will measure the discrepancy when your child is standing barefoot. He or she will place a series of wooden blocks under the short leg until the hips are level, then measure the blocks to determine the discrepancy.
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. Imaging Studies
. X-rays. An x-ray provides images of dense structures, such as bone. If your doctor needs a more precise measurement of the discrepancy, he or she may order x-rays of your child's legs.
. Scanograms. This is a special type of x-ray that uses a series of three images and a ruler to measure the length of the bones in the legs. Your doctor may order a scanogram instead of, or in addition to, a traditional x-ray.
. Computerized tomography (CT) scans. These studies can provide a more detailed image of the bone and soft tissue in the legs. In some cases, your doctor will use a CT scan to measure the limb length discrepancy.
If your child is still growing, your doctor may repeat the physical examination and imaging studies every six months to a year to see if the discrepancy has increased or remained the same.
Because an x-ray measurement cannot be compared with a CT scan measurement, your doctor will follow your child with the same type of imaging study over time.
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