Congenital pseudarthrosis - tibia/fibula

Case contributed by Dr Ammar Haouimi

Presentation

Progressive deformity of the right leg

Patient Data

Age: 10 years
Gender: Male

Anterolateral bowing of the right leg

Anterolateral angulation of the tibial shaft at the junction of the middle and distal thirds with cortical thickening (mainly posterior), reducing the diameter of the medullary canal associated with some subcortical cystic changes at the same level (type III according to Crawford's classification)

The fibula appears gracile in morphology with anterior angulation (acute angle) at the junction of the middle and distal thirds of the fibular shaft with resorption of a short segment at the same level, giving the appearance of joint. Note the sharpened narrow appearance of the bone proximal to the absent section and cupping of the bone distal to the absent section (type IV according to Crawford's classification)  

Case Discussion

Radiological appearances of a congenital pseudoarthrosis, usually seen in neurofibromatosis type 1 (or von Recklinghausen disease) as was the cause in this case.

Additional contributor: Prof N Khernane, orthopedic surgeon.

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