Congenital pseudoarthrosis of the tibia

Dr Rohit Sharma and Dr Andrew Dixon et al.

Congenital pseudoarthrosis of the tibia describes abnormal bowing that can progress to a segment of bone loss simulating the appearance of a joint. The condition is usually apparent shortly after birth and is rarely diagnosed after the age of two.


The etiology is unclear, however, around 50% of cases are associated with neurofibromatosis type 1 (NF1). Overall, 10% of patients with NF1 are diagnosed with tibial pseudoarthrosis.

Fibular, ulnar, and radial pseudoarthroses can also occur, but much less frequently, and usually only in patients with NF1.

Radiographic features

  • progressive bowing (usually anterolateral in the tibia)
  • resorption of a short segment of bone
    • usually at the site of maximal bowing
    • usually between mid and distal one-third of the shaft
  • angulation at the site of absent bone segment
  • often mimics the appearance of a joint
    • cupping of the bone proximal to the absent section
    • sharpened narrow appearance of the distal bone
  • often fracture or bowing of accompanying bone (fibula with tibia, radius with ulna)

Article information

rID: 10332
Synonyms or Alternate Spellings:
  • Tibial pseudoarthrosis (congenital)
  • Congenital ulnar pseudoarthrosis
  • Ulnar pseudoarthrosis (congenital)
  • Radial pseudoarthrosis (congenital)
  • Congenital radial pseudoarthrosis
  • Fibular pseudoarthrosis (congenital)
  • Congenital fibular pseudoarthrosis

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Cases and figures

  • Case 1: tibial pseudoarthrosis (NF1)
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  • Case 2: tibial pseudoarthrosis (NF1)
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  • Case 3: fibular pseudoarthrosis (NF1)
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  • Case 4: ulnar pseudoarthrosis (NF1)
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  • Case 5: ulnar pseudoarthrosis (NF1)
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