Prominent soleal line: tibial pseudoperiostitis
Patient presents with knee pain, incidental finding
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Markedly prominent ossification obliquely across the upper tibias at the origin of the soleal muscles seen as a thick osseous protrusion on the lateral projection. This is not pathological. Note also ossification at the quadriceps insertion into the upper patella and tibial insertion of the patellar tendon.
This variant is bilateral and symmetrical, in an anatomical plane and osseous, and should not be confused with pathological heterotopic bone or periosteal elevation. It has been termed pseudoperiostitis by Levine, et al.