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Abnormality of the left proximal tibial metaphysis with varus deformity.
Local disturbance of growth of the medial proximal tibial epiphysis contributing to tibia vara. There is an infantile and adolescent variety.
The infantile type is 5 times more frequent than the adolescent and is seen particularly in early walkers. It appears to be the result of abnormal compressive forces inhibiting growth at the medial growth plate and not from avascular necrosis.
The condition is commonly bilateral. Clinically, the child presents with bowing of leg. Radiologically, the tibial shaft is in varus position. The epiphysis is wedge-shaped, fragmented or appears absent. The adjacent metaphysis is also depressed and has a beak-like protuberance of rarified bone oriented medially. Pre-operative MRI can be used to detect physeal bone bars.
Credit: Dr Ahmed Abou Issa