Radiology of postnatal skeletal development

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Abstract
Ossification usually begins in the proximal tibia within the first three months following birth. The initial secondary ossification is centrally located and spherical. Expansion and maturation then changes the ossification center to a more elliptical shape. Variability in this expansion medially and laterally may create marginal irregularity in the first few years, followed by a smooth border by five to six years. Subsequently ossification extends into the tibial spines as a single conical mass which eventually divides into two separate extensions. The physis remains relatively transverse throughout development although contouring occurs under each tibial weight-bearing compartment. Peripheral lappet formation appears within a few months. Anteriorly there is an undulation at the site of the cartilaginous tibial tuberosity.

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