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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