Blount disease

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Rx legs under load. Difficulty walking.

Patient Data

Age: 2 years
Gender: Male
x-ray

Enlargement and irregularity of the medial growth plate cartilage of the proximal tibia with medial bony prominence ("bone beak") at the level of the tibia metaphysis, associated with a sharp angle between epiphysis and metaphysis.

The diaphyseal-metaphyseal angle of Drennan is 12.2° on the right and 12.1° on the left (normal <11°).

Case Discussion

Children with Blount's disease have a knee varus that during the second year of life tends to worsen. This distinguishes this from the physiological varus deformity (or tibia vara intraruotata physiological), which instead tends to improve spontaneously.

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