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Special Feature
August 2008

Picture of the Month—Quiz Case

Author Affiliations

Author Affiliations: Department of Pediatrics, University of Kansas Medical Center, Kansas City. Dr Shastri is now with the Department of Pediatrics, Children's Mercy South Urgent Care Center, Children's Mercy Hospital and Clinic, Overland Park, Kansas.



Arch Pediatr Adolesc Med. 2008;162(8):787. doi:10.1001/archpedi.162.8.787

A term baby girl was born by spontaneous vaginal delivery to a healthy mother. Her Apgar scores were 9 at both 1 and 5 minutes. Her birth weight was 3488 g with a gestational age of 39 weeks, which made her appropriate for her age. Her presentation was vertex. There was no history of oligohydramnios. On examination, there was a deformity of the right knee with hyperextension (Figure 1). It was possible to flex the right knee joint fully. The baby did not cry during any manipulation of her right knee joint. The left knee and both hip joints were normal. Ortolani and Barlow test results were negative. There was no foot deformity. There was no family history of knee, hip, or foot deformity.

Hyperextension of the right knee joint.

Hyperextension of the right knee joint.

What is your diagnosis?