This radiograph is most suggestive of Blount disease (tibia vara), a growth disorder affecting the inner (medial) upper tibia that causes progressive bowing of the leg.

The proximal medial tibia appears irregular and sloped, with early medial metaphyseal beaking, which are characteristic radiographic features. Blount disease can be infantile or adolescent-onset and may be associated with obesity and progressive bow-leg deformity. NCBI review of Blount disease describes these findings.

A definite diagnosis needs the patient's age, examination, and preferably a standing full-length lower-limb alignment X-ray with measurement of the tibial angles. Rickets and physiologic bowing can sometimes resemble it, though rickets usually has more widespread metaphyseal cupping/fraying.