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    Go to the top of the page   ID: 20100128133421 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    | The Authors | Discussion | Write a Comment to this Case |
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    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Sanjeeb Kumar Sarma (Down Town Hospital/Guwahati/India)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Generalized diseases  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    3 years old emaciated male patient brought to our hospital with inability to stand or walk properly.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The skeletal effects of rickets are due to lack of calcification of osteoid. As a result most obvious changes are seen at metaphysis where the most rapid growth occurs. The earliest changes are loss of normal “zone of provisional calcification” adjacent to metaphysis featuring as indistinctness of metaphyseal margin. This progressed to a “frayed” appearance with widening of the growth plate due to lack of calcification of metaphyseal bone. Weight bearing and stress on the uncalcified bone give rise to “splaying” and “cupping” of the metaphysis. A similar but less marked effect occurs in the sub-periosteal layer causing loss of distinctness of cortical margin. Generalized osteopenia occurs, however, looser’s zones are distinctly uncommon.
    In severe cases additional deformities like bowing of long bones particularly of lower bones, thoracic kyphosis with a pigeon chest, enlargement of anterior ribs causing ricketic rosary and bossing of the skull. In low birth weight premature babies features of rickets may be very severe with spontaneous fractures and respiratory difficulty. Affected infants are usually bellow 1000 g in weight or less than 28 weeks of gestation.
    Treatment is dietary supplement of vitamin D.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Expert's opinion  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Hypophosphatasia, NAI etc  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Prognosis is good with timely intervention.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Patient is undergoing treatment.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Rickets, vitamin D, splaying, fraying, cupping, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Generalized diseases
    or in the region: Generalized diseases
    or in the tissue/organ:
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

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    Rickets
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   

    Rickets  
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)



        Total answers: 39

     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

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    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     




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