Clinical presentation:
Warm painless swelling of leg in a wheelchair-bound child.

There is deformity of the metaphysis of adjacent ends of right femur and tibia. The distal femoral epiphysis is much enlarged as from previous fracture. The distal metaphysis of the femur is widened and its posterior cortical boundary crosses the diaphysis as a line of sclerosis, suggesting previous fracture. There is a separated triangular fragment from the posterior of the proximal tibial metaphysis. The centre of radius of the proximal tibial epiphysis is displaced posteriorly. Anteriorly there is a new bone density, separate from the line of the anterior cortex of the tibia. The appearance suggests in-filling of the space between the bone and an avulsed tibial tuberosity with adjacent periosteum.

Clinical presentation:
Another child with treated hydrocephalus.

The legs are externally rotated. There are two fragments each anterior or posterior to the upper left tibial metaphysis. The centre of radius of the proximal left tibial epiphysis is slightly posterior. There is modeling deformity of the left tibial proximal metaphysis that suggests different times for each of the metaphyseal injuries.