Case of the Week: April 12-April 19, 2012

1 year old, diagnosis please?

(Click for a larger image.)



Case Details

Metaphyseal fraying and splaying.

Answer

Diagnosis: Rickets

Normal bone development depends on ready availability of calcium, phosphorus and vitamin D.
Rickets is a consequence of decreased availability of these substances.
Calcium and Phosphorus is essential for formation of hydroxyapatite crystals.
Vitamin D promotes calcium absorption from intestine, calcium resorption from proximal renal tubules, regulates apoptosis of chondrocytes, mineralization of cartilage matrix and metaphyseal angiogenesis.
Widening and irregularity of the growth plate-Fraying
Widening of the metaphyseal end of bone-Splaying
Concavity of the metaphysis-Cupping
Medications causing Rickets: Dilantin
 Ifosfamide
Oncogenic Rickets-Paraneoplastic syndromes that has been reported with non-ossifying fibroma,hemangiopericytoma,osteoblastoma and linear sebaceous nevus syndrome

 

Correct answers by users

VCU Resident
Radiology Pediatrics
  • Susan Back
  • Jeremy Camden
  • Mamta Gupta
  • Mack Hendrix
  • Brian Moon
  • Bradford Moore
  • David Ratliff
  • Fatmeh Diab
    Others
  • Mehtab AhmadIndia
  • Shymaa AhmadEgypt
  • Mohammad AL -DrihiSyria
  • Watfa Al DhaheriCanada
  • Amer AlarefCanada
  • Mudit AroraIndia
  • Swapnil BagadeUnited States of America
  • Bakhtiar BakhshiTurkey
  • Danz BeltsazarIndonesia
  • RAKESH BHATIAIndia
  • Stephanie BurnsUnited States of America
  • AHMED EIDSaudi Arabia
  • Hesham EL-KhwalkaKuwait
  • Salim ElzawamLibya
  • Aiser GlayaCanada
  • Saad HassanSaudi Arabia
  • Syed IslamSaudi Arabia
  • Ramazan JafariIran
  • Amol JagdaleIndia
  • Imran JindaniIndia
  • Kathryn JonesUnited States of America
  • John KirkhamUnited States of America
  • Naganathan ManiUnited States of America
  • Adam McLaurinUnited States of America
  • Uma MehtaUnited Arab Emirates
  • Ehab MohamedSaudi Arabia
  • Kaustubh NarsinghpuraIndia
  • Robert PalmerUnited States of America
  • Suhasini PokanatiIndia
  • Shohreh RezaiAustralia
  • Cristina RoscaRomania
  • Theka SalmanIraq
  • Mohamed ShoukryEgypt
  • Eisha TahirPakistan
  • S VelaUnited States of America
  • Carolyn WassongUnited States of America
  • Trevor WatkinsAustralia
  • Lincoln WongUnited States of America
    VCU Department of Pediatric Radiology Virginia Commonwealth University VCU Medical Center