The rotation of the femur can be normal or abnormal. Abnormal values are usually described as more than two standard deviations from the mean for a given age. The primary concern remains the appearance of the child's legs while walking or running. Pain is rare.
Family history is helpful in making the diagnosis.
Physical examination should include an assessment from the hips to toes. Patients with femoral anteversion usually show medially directed patella and increased internal rotation compared to external rotation in the prone position. In-toeing and scissoring gait are also common while walking. Tibia torsion is commonly associated with femoral anteversion. The limb bud begins to form in the first trimester.