Tibial hemimelia

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Right lower limb shortening and deformity.

Patient Data

Age: 5-months old
Gender: Male
x-ray

Shortening of the right tibia (compared to the left side) with hypoplasia of its distal shaft.

  • the right fibula shows upward displacement of its proximal portion and medial bowing of its mid-shaft

  • equinovarus deformity of the ankle and foot

  • shortening of the right lower limb

The right foot shows:

  • short 1st and 3rd metatarsal bones

  • severely hypoplastic deformed 3rd and 4th proximal phalanges with transversely oriented extra-phalanx seen within their inter-phalangeal space

  • hypoplastic distal phalanges of the 2nd to the 5th toes and the middle phalanges of the 3rd, 4th and 5th toes

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