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An overweight 14 year old Afro-Caribbean girl presented with painless bowing of both knees. She had significant genu varum and internal rotation of the proximal tibia. Radiographs showed a varus deformity of greater than 11 degrees, bridging of the physis, and “beaking” of the proximal medial tibial metaphysis, characteristic of Blount's disease. She was treated with a high tibial osteotomy. Blount's disease is premature ossification of the proximal tibial physis caused by abnormal loading; it should not be confused with physiological genu varum, which involves a deformity in both the tibia and distal femur and is usually treated non-operatively.non-operatively.