Rickets
X-ray Photograph showing AP Pelvis and Knees with widening of metaphysis and cupping of epiphysis in keeping with a metabolic condition such as Rickets.
d/d - Generalized Skeletal Dysplasia
What is Rickets ?
Disease of growing bone unique to children and adolescents. Cause - failure of osteoid to calcify in a growing bone. Failure to calcify in adults is called Osteosarcoma.
Causes of Rickets
Nutritional- sources - fatty fish, salmon ,sardines, morgarines, milk
Lack of sunlight
Congenital rickets
Rickets of prematurity
Vitamin D resistant Rickets
Hypophosphatemic Ricekts
Drug induced rickets
How else might a child with rickets present ?
Generalized muscular hypotonia
knobby swelling at end of long bones-uncalcified osteoid at metaphysis leads to spreading of the areas (cupping and flaring radiologically )
Rachitic Rosary on chest -knobby swelling on costochondral junction
Harrison Groove - weakened ribs pulled by muscles producing flaring over sternum.
Pigeon Chest deformity
Ankle - palpation of tibial malleolus gives impression of a double epiphysis (marfan sign )
Blood tests
Calcium level decrease
PTH level increase
25 Hydroxy Vitamin D (Calcidiol
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