Rickets: The Daily PANCE Blueprint

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Rickets: The Daily PANCE Blueprint

A mom brings in her 2-year-old son as she has noticed that his legs are bowing and there is worsening swelling of his wrist/ankle joints. After getting a good history, you figure out her son stays inside all day and is an extremely picky eater. Which of the following radiographic findings will you most likely see?

A. Widening/cupping of metaphysics with brush-like ends
B. “Hair on end” appearance of the skull
C. Loss of trabeculae in the proximal femur area
D. Mixed lytic and sclerotic lesions of the skull
E. Coarsening of the trabecular bone with cyst-like lucencies

Answer and topic summary

The answer is A. Widening/cupping of metaphysics with brush-like ends

Rickets is defined as the lack of mineralization and inadequate expansion of growth plate cartilages in kids. It is due to Vitamin D deficiency. Causes of Vitamin D deficiency can include malnutrition, inadequate sun exposure, genetics, medications, and renal disease. On physical exam, you may see frontal bossing, bowing of the legs, pectus carinatum, and swelling of the wrist and ankle joints. Radiograph findings include widening/cupping of metaphysics with brush-like ends. Treatment is vitamin D and calcium supplements and diet changes.

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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Metabolic Disorders ⇒ Rickets

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