Early characteristic findings in bowleg deformities: evaluation using magnetic resonance imaging
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Updated: Oct 13, 2026
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
1Department of Orthopaedics, Shiga Medical Center for Children, Japan. smukai@kuhp.kyoto-u.ac.jp
Insights
Magnetic resonance imaging (MRI) identified distinct infantile bowleg patterns. Early signs of Blount
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Radiology
Background:
- Bowleg deformities (genu varum) are common in infants.
- Distinguishing physiologic bowing from early Blount's disease is clinically important.
- Magnetic resonance imaging (MRI) offers detailed visualization of bone and cartilage structures.
Purpose of the Study:
- To evaluate the utility of MRI in assessing infantile bowleg deformities.
- To identify MRI characteristics differentiating normal bowing from early Blount's disease.
- To explore potential common pathomechanisms between infantile bowing and Blount's disease.
Main Methods:
- Retrospective analysis of MRI scans from 13 infants (25 tibiae) with bowleg deformities.
- Classification of MRI findings into two groups based on medial epiphyseal cartilage and physeal characteristics.
- Correlation of MRI findings with clinical follow-up and radiographic measurements (metaphyseal-diaphyseal angle).
Main Results:
- Group A (medial epiphyseal cartilage high intensity) showed normal lower leg alignment.
- Group B (medial physeal depression, perichondrial signal abnormality) included five cases with Blount's disease.
- MRI findings in Group B suggest preliminary changes of early-stage Blount's disease; high medial epiphyseal signal is common in bowing.
Conclusions:
- MRI can differentiate infantile bowleg deformities.
- Abnormalities in the physis and perichondrial region on MRI may indicate early Blount's disease.
- Shared pathomechanisms may exist between physiologic bowing and infantile Blount's disease, suggested by common epiphyseal MRI findings.
Abstract:
We used magnetic resonance imaging (MRI) to evaluate bowleg deformities in infancy. Twenty-five tibiae of 13 infants were examined and divided into two groups based on MRI findings: group A had high intensity area in the medial epiphyseal cartilage on T2-weighted images. Group B had depression of medial physis and abnormal signal in the perichondrial region in addition to the epiphyseal lesion. At the final follow-up, all cases in group A demonstrated normal lower leg alignments, whereas five cases in group B showed characteristic roentogenographic findings of Blount's disease. The improvement rate of metaphyseal-diaphyseal angle was correlated with this classification. These findings suggested that abnormal findings in physis and perichondrial region might be preliminary findings in early stage of Blount's disease. The high intensity areas in the medial epiphyseal cartilage were commonly found among the cases with bowing deformities, which suggested that there might be a common pathomechanism between physiologic bowing and infantile Blount's disease.
