Click on Images for Enlarged View

Findings: Diffuse osteopenia is evident. There is widening of the growth plate. The femoral and tibial metaphysis are frayed and cupped.

Diagnosis: Rickets

Discussion: Rickets is described as a group of diseases demonstrating similar pathologic, radiologic, and histologic abnormalities. Pathologically, it results from an interruption in the orderly development and mineralization of the growth plate, so changes are more obvious in regions of most active growth, i.e. the costrochondral junction of the ribs, the distal femur, proximal humerus, both ends of the tibia and distal radius and ulna. This results in widening of the growth plate and zone of provisional calcification which becomes irregular. Disorganization and "fraying" with widening and cupping of the metaphyis.

The deformities caused by rickets exhibit different patterns depending on the child's age when the disease develops. In infants, craniotabes is a manifestation. During infancy and childhood, long bone abnormalities predominate with bowing deformities. Later on scoliosis, basilar invagination, and triradiate configuration of the pelvis may be seen.

There are many well-established etiologies to rachitic and osteomalacic syndromes; abnormalities related to vitamin D, syndromes secondary to renal tubular loss of phosphate, and abnormalities calcium-phosphorus homeostasis.

Return to Pediatric Imaging Page