Differences in foot appearance and position noticed by parents most often reflect variations of normal physiological development.[46] Unfamiliarity with normal lower-extremity growth and development, and desire for normal alignment in their children, may explain parents' concern and motivation to seek medical advice. Accurate diagnosis of torsional problems involves understanding the reason for consultation, taking parents' concerns seriously, taking a detailed history of the problem, performing a screening examination to rule out pathological causes, and measuring severity with a rotational profile. Radiographical evaluation is rarely indicated unless a pathological condition is suspected.

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