What causes a gap between the knees?

Q: My four years old daughter has a leg problem. I can notice a gap between her knees when she stands straight. Usually our knee touches each other while standing straight. There is also a huge gap between her ankles. When I try to touch her ankle with another, her knees overlap with each other. What causes a gap between knees?

A:In the normal course of development in children, it is normal to have an apparent bow-leggedness in the 1st 2 years of life, and then have "knock-knees" between 2 and 6 years of age, before the legs straighten out like in adults.

Having stated the above, if the situation gets reversed or the distance between the knees or ankles is exaggerated while bearing weight or the deformity is asymmetrical, then the situation requires investigation. It does seem that there may be an exaggeration of the deformity. Your child needs to be assessed by an Orthopaedic - surgeon.