Clinical features of rickets : craniotabes, frontal bossing , widening of wrists and ankle joints etc
It is a a disease of growing bones.
Bone consists of a protein matrix i.e osteoid and a mineral phase (composed
of calcium & phosphate) mostly in the form of hydroxyapatite .
Caused by unmineralised matrix at the growth plates in children only before
fusion of the epiphyses.
There occurs thickening of the growth plate.
Clinical features:
1. General: Failure to thrive
2. Head : frontal bossing , craniotabes
3.Chest : Rachitic rosary , Harrison groove
4. Enlargement of wrists & ankle joints, valgus or varus deformities
Bowing of legs.
5.Hypocalcemic symptoms: tetany,seizures etc
6.Scoliosis,Kyphosis
CRANIOTABES is the early sign that should be looked
in early infancy (i.e around 3months of age). It occurs due to softening of the outer table of the
cranial bones. It can be detected by applying pressure at the occiput or
over the parietal bones (away from sutures line). Ping-Pong Ball
Frontal bossing: Prominence of frontal bones , (due to deposition of excess osteoid and non-calcified cartilage
over frontal & parietal region)
Anterior fontanelle remains wide open and
its closure is delayed.
Delayed eruption of teeth
Harrison’s sulcus :
horizontal groove along the attachment of diaphragm. (due to constant pulling of the soft lower ribs
by the diaphragm)
Pectus carinatum or pigeon chest :
(forward projection of the sternum)
Kyphosis (Exaggerated forward curvature of the spine)
X-ray findings: FRAYING : indistinct margins of the metaphysis
SPLAYING : widening of metaphyseal ends
CUPPING : concavity of metaphysis
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