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Background
Tibial pathologies are common in the pediatric age group. Patient age, clinical symptoms, and other associated imaging findings can help make the correct diagnosis.

Educational Goals / Teaching Points
Through our exhibit, we will review imaging of a broad spectrum of tibial pathologies in the pediatric age group. These include a variety of congenital, developmental, traumatic, metabolic, infective, inflammatory, and benign and malignant neoplastic pathologic processes.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Our exhibit reviews tibial pathologies, such as congenital bowing, pseudo-arthrosis, Blount disease, neurofibromatosis, congenital syphilis, osteomyelitis, chronic recurrent multifocal osteomyelitis, and tumors. Radiologists must be familiar with the normal radiographic appearance of the tibia in a skeletally-immature child. One should know how to differentiate physiologic from pathologic bowing. Radiographs play a vital role in the pediatric age group. Certain classic features can point towards nonaccidental trauma. Pathologies like congenital syphilis, rickets, and Brodie abscess demonstrate typical radiographic features. It is essential to know that fractures involving proximal tibial metaphysis may result in a valgus deformity and should have an orthopedic follow-up examination. Radiologists should be wise in deciding which modality to go for based on multiple factors, including clinical suspicion and the patient’s age.

Conclusion
Pathological processes involving the tibia are common in children. We will illustrate the imaging spectrum of tibial pathologies in the pediatric age group and discuss various radiological features that can help make the correct diagnosis.