Little Gabrielle, three and a half, sat mutely on the examining table, watching my every move. Her legs dangled over the edge of the paper-covered vinyl, revealing a right knee that protruded about an inch farther than the left.
"You can fix her, can't you, Doctor?" her mother asked anxiously. "She's my dancer."
"Her pediatrician was very concerned," I said, evading the question. In fact, her pediatrician had bypassed the formality of an orthopedic consult and brought the X-rays straight to my office door. Orthopedic surgery is rooted in a long tradition of preventing deformity in children. (Orthopedics comes from two Greek words meaning "straight" and "child.") A crooked tree braced to a post is the emblem of the American Academy of Orthopaedic Surgeons. As the twig is bent, so grows the tree.
I skimmed the meager entries in Gabrielle's chart, trying to figure out how the asymmetry of her legs had been missed for so long. She had been seen by our medical group for about two years; while generally healthy, she had had routine visits for sore throats, ear infections, and immunizations. How could her family have missed this?
