Professional Documents
Culture Documents
CAUSES of rickets :
1. Abnormality in vitamin D metabolism
2. Abnormality in phosphate metabolism
3. Calcium deficiency
VITAMIN D :THE SUNSHINE VITAMIN
SOURCES of vitamin D
• Sun light
-synthesized in body
from precursor sterol
• All milk products
(fortified)
• Cod liver oil
• Egg yolk
VITAMIN D METABOLISM
Hypocalcaemic rickets(with secondary
hyperparathyroidism)
• Occipital alopecia
• Muscular hypotonia (floppy baby syndrome)
• Constipation
• Hypocalcaemic tetany
• Anaemia
• Increased risk of respiratory infections
• Growth retardation and low height for age (rachitic dwarfism)
PATHOGENESIS of Rickets
Radiological features(ACTIVE RICKETS)
WIDENING OF
GROWTH
PLATE
• Earliest radiological
sign is loss of zone of
provisional
calcification adjacent
to metaphysis.
• Due to deposition of
excess un-mineralized
osteoid.
METAPHYSEAL
FRAYING
• Irregular metaphyseal
margins occurring due to
fraying and disorganization
of spongy bone in the
metaphyseal region.
METAPHYSEAL CUPPING
AND SPLAYING
• Protrusion of bulky mass
of cartilaginous cells in
the zone of hypertrophy
into poorly mineralized
metaphysis.
EPIPHYSEAL ABNORMALITY
• Osteopenia
• Irregular and indistinct
borders
• Delayed appearance of
ossification centres.
SHAFT ABNORMALITIES
• Bone density is reduced
due to loss of mineral
content.
• Cortex become thin with a
course trabeculation.
GROWTH PLATE
ABNORMALITIES
• Generalised osteopenia
• Course trabecular pattern
• Frayed paintbrush
metaphyseal
margins(arrows)
• Lack of zone of provisional
calcification
• Widening of the physis
CRANIOTABES
• Occurs due to thinning of outer
table of occipital or parietal
bone.
• vitamin D supplementation of
200-400 IU/day.