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Findings: Films reveal widening and fraying of the metaphysis and physis in the radius, ulna, distal femurs and proximal fibula.

Diagnosis: Rickets.

Discussion: Rickets is a disorder of bone mineralization in which osteoblastic activity and production of bone matrix continue but matrix mineralization is delayed.

The most important physiologic basis of rickets is a deficiency of extracellular phosphate, with or without an associated deficiency of calcium. Etiology of rickets can be divided into two main categories:

1. Diminished/ineffective production of active Vit D. This includes
decreased oral intake of Vit D, limited sunlight, liver disease or Vit D malabsorption.

2. Renal abnormalities, which includes Fanconi Syndrome and renal tubular acidosis.
Treatment includes Vit D replacement.

References:
Rudolph, Pediatrics, pg. 236-239.

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