Lateral (A) and anteroposterior (B) radiographic views of a child with increasing pain over 1 month; both the patient and her parents deny a history of trauma.


Published 4/1/2012

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted.

The images for this month’s challenge were submitted by Nicholas Larsen, MD, a resident member at the University of Tennessee-Campbell Clinic. Dr. Larsen also provided the following information:

The patient is a 7-year-old girl with a 1-month history of increasing pain in her left leg. The pain increases when she spends long periods on her feet and resolves with rest. She does not have pain at rest. Both the child and her parents deny any trauma. What’s your diagnosis?

Find the answer to this month’s challenge below

Larger image (PDF)

According to Nicholas Larsen, MD, who submitted the case, the diagnosis is congenital pseudarthrosis of the tibia and fibula, with no evidence of neurofibromatosis.

Send AAOS Now your case
Do you have a challenging case you’d like to submit for publication? Email a short case description and any accompanying images to