Saturday, September 19, 2009

Differential Diagnosis of Unilateral Tibial Bowing

Anterolateral bowing Anteromedial bowing
  • Fibular hemimelia: Linked to the sonic hedge-hog gene. May also see skin dimpling over the tibia, equinovalgus foot, missing lateral toes, and tarsal coalition.
Posteromedial bowing
  • Calcaneovalgus foot deformity: resolves with growth. Also associated with limb-length inequality and triceps surae weakness.
Lateral bowing
  • Physiologic in infants
  • Abnormalities of the medial physis: Fracture malunion, Blount disease, Turner syndrome, rickets, hypophosphatasia
  • Fibrocartilaginous dysplasia At the site of pes anserinus tendon insertion.
Special thanks to Dr. James Dimaala for the case of anterolateral tibial bowing in a patient with neurofibromatosis type I.

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