The proximal tibio fibular joint. An anatomical study with clinical and pathological considerations.

The proximal tibiofibular joint (TFJ) was studied in 489 dry bones and 50 specimens of dissected knees. A marked variability in morphological characteristics was found with frequent osteoarthritic changes. The most common types of joint found were the trochoid and the double trochoid, followed by the plane type. No articular facet could be recognised in 10 dry fibulae and 12 dry tibiae. The inclination of the joint ranged between 5 degrees and 80 degrees. Osteoarthritis of some degree was present in the TFJ joint in 83 fibulae (27%) and 80 tibiae (38%). It was associated with osteoarthritis of the knee joint, especially affecting the medial compartment, in 30% of cases. Osteoarthritis of the TFJ was also found in a case of multiple exostoses and in a specimen with Bejel disease. No correlation could be established between the presence of the 'squating facets' in the distal end of the tibia and the morphological characteristics or pathology of the TFJ. A clinical case of osteoarthritis of the TFJ in a women of 57 is presented, and the differential diagnosis of pain over the lateral aspect of the knee is discussed.