A 29 year old man came with complaints of pain and swelling in the left ankle and foot since one month. He gave history of multiple episodes of similar complaints at the same site. The patient is known to have hemophilia.
Radiographs of the left foot show severe osteoporosis with coarse trabecular pattern of bones. There is ill defined widening and enlargement of the distal end of the tibia with loss of joint space between the tibia and the talus. There is partial bone bridging across this joint. There is an old fracture of the lower third of the fibula.