Will my grandson’s foot ever untwist? - DR ROSEMARY answers your health questions

A - In-toeing is very common in young children. We are all born with an inward twist of the thigh bone (the femur) at the hip joint, known medically as femoral anteversion.

Although most of us grow out of this by the age of two, in some children the twist may not disappear until the age of eight.

They often kneel with their legs in a “W” position, with their feet outside the thighs. In a few children, femoral anteversion persists but it very rarely causes any functional problems and those with it can participate normally in sports.

In-toeing can also be caused by an inward twist of the main shin bone (the tibia) at the knee, although again, this usually corrects with age and does not need any treatment.

The third possible cause of in-toeing is feet that curve inwards, which is often seen in children who sleep face-down.

More than 80 per cent of children with this condition grow out of it by the age of four but if not, in those with pronounced problems, special shoes, or splints that are worn at night, can be helpful.

The majority of children with this condition do not complain of any symptoms, can participate in all normal activities and have no long-term problems.

It sounds as though your grandson’s parents have had medical advice so I do not think you need to be concerned and remember that the last thing he will want is to be made to feel self-conscious about it. 

Q - I am a 94-year-old woman in good health but I’ve recently noticed that my nails have become ridged. What causes this and what can I do to get rid of it? 

A - Nail ridges can occur in two directions – vertically, from the cuticle to the tip or horizontally across the nail.

Vertical ridges are fairly common, especially in older people and in most it is a sign of the normal ageing process in nails. Nails are formed in a layer of cells known as the nail bed.

With age, the blood supply to this decreases. It also loses its ability to absorb nutrients needed for healthy nails and this can lead to uneven growth.

Horizontal ridging is most commonly caused by trauma, such as picking at or over-zealous removal of the cuticles but it can also be due to illness or poor nutrition affecting the nail bed.

Chemotherapy patients often get horizontal ridges which disappear once treatment stops.

In most people ridged nails are nothing to be concerned about but it would be worth mentioning next time you see your doctor.

Q - I Have been diagnosed with “benign essential tremor”, a condition that causes me to shake and tremble, which can be very embarrassing. Because I am asthmatic, the treatments available are unsuitable for me. In the past couple of years my condition has deteriorated. Is there anything I can do? 

A - When you have essential tremor, parts of your body shake and you have no control over this.

It nearly always starts in the arms and later may affect the legs as well and, more rarely, the head. It doesn’t happen all the time and is more likely to occur when you are tired, hungry or feeling emotional.

No underlying cause can be found and it is now known that it can run in families. It affects one in 250 people in the UK to some degree. Men and women are affected equally and it usually starts after the age of 40. The most common treatment is propranolol, a beta blocker.

Unfortunately beta blockers can narrow the airway, so are not suitable for people with asthma. A good alternative is primidone.

Side effects can include sleepiness, dizziness and nausea, although these usually improve if you continue with the medicine. It’s normal to start with a very low dose, which is gradually increased until the tremor has eased. If this fails, topiramate and gabapentin are worth a try. 

● If you have a health question for Dr Rosemary please write to her in confidence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN or email health@ express.co.uk Dr Rosemary’s reply will appear in this column. She regrets that she cannot enter into personal correspondence and that, due to the volume of letters, she cannot reply to everyone. Find out more about Dr Rosemary at drrosemaryleonard.co.uk