School ager with a myelomeningocele who is insensate in the lower extremities who had left varus derotation osteotomy surgery 2 months ago and now has new left thigh swelling

Radiograph of congenital insensitivity to pain resulting in exuberant periosteal reaction
AP (left) and lateral (right) radiographs of the left femur show a normal post operative appearance to the left hip plate and screws. There is exuberant periosteal reaction present along the femur. There is an irregular lucency in the distal femoral metaphysis.

The diagnosis was congenital insensitivity to pain resulting in exuberant periosteal reaction from an undiagnosed nondisplaced distal femur fracture.