Ossicles anterior to the anterior tibia are most usually seen in relat
ion to the tibial tuberosity. While these are usually taken to represe
nt sequelae of previous Osgood-Schlatter disease, they may, on occasio
n, represent normal variants in ossification of the tuberosity. Ossicl
es superior to the tuberosity may have similar origins. Representative
examples are presented, as is a very large ossicle separated from the
anterior tibia by a prolongation of the knee joint space. Theories of
causation of such ossicles are discussed.