Presentation
Progressive deformity of the right leg
Patient Data
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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