Tibial bowing in children - what is normal? A radiographic study.

Abstract

PURPOSE: To define osseous landmarks on tibia radiographs in order to establish age-related normal values characterizing physiological tibial bowing in children. MATERIALS AND METHODS: Five hundred and twenty-six patients aged 0-17 years with normal radiographs of the lower legs were identified and retrospectively reviewed by two blinded radiologists. In anteroposterior (ap)/lateral (lat)-views, 3 lines defined tibial length and angulation. Line-A connecting proximal to distal corner of tibial metaphysic, lines B and C corresponding to corners of tibial metaphysis. Angle A/B defines proximal, A/C distal tibial-angulation. Tibial curvature is defined by distance of line-D parallel to A and ta..