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Blount disease

Case contributed by Jeremy Jones
Diagnosis almost certain

Presentation

Left knee pain and abnormal alignment of the lower leg on examination with leg genu valgum.

Patient Data

Age: 10 years
Gender: Male
x-ray

There is abnormality of the medial component of the left proximal tibia with involvement of the epiphysis, physis and metaphysis. Deep physeal clefts extend into the metaphysis and there is associated sclerosis and deformity.

mri

As demonstrated on the plain film, there are a constellation of findings centered around the medial portion of the left proximal tibia.

The epiphysis is only partly ossified but is covered in cartilage.

The medial physis is abnormal with deep metaphyseal clefts and widening and down-turning of the physis. There is associated bone edema.

Case Discussion

Features here are consistent with early Blount disease with disruption of the medial portion of the physis and resultant bone edema and deformity. Patients may have medial meniscal hypertrophy.

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