On a plain radiograph (X-ray) I reviewed recently, I encountered a classic lesion straight out of a textbook: A broad-based bony outgrowth located at the proximal medial metaphysis of the tibia, demonstrating clear corticomedullary continuity with the parent bone and projecting distally (downward) away from the growth plate. When we first encounter this image, a single term immediately comes to mind: Exostosis. However, right at this juncture, one of the most intriguing debat