Out-toeing

​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • new diagnosis of Slipped Upper Femoral Epiphysis (SUFE)
  • suspected fracture

Note: pelvic x-rays: anterior to posterior (AP) and frog leg lateral views are required for all children aged > 10 years presenting with out-toeing

When public outpatient services are not routinely provided

Out-toeing and aged < 2 years (in otherwise normal child)

Criteria to access public outpatient services​

Category
Criteria

Category 2
Recommended to be seen within 90 calendar days.

Out-toeing with pain
​Note: consider fracture as a diagnosis

Category 3
Recommended to be seen within 365 calendar days.

Out-toeing with any of the following:

  • unilateral deformity
  • persistent or progressive deformity
  • functional difficulties (excluding infants)
  • thigh-foot angle > 30-40 degrees external

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition including evolution and duration of symptoms
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • assessment of gait
    • treatment prescribed (analgesics, physiotherapy)
    • relevant family history
    • x-ray: pelvis - anterior to posterior (AP) and frog leg lateral views (if asymmetrical deformity or acute onset)

If available

  • Nil​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.


 

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing