Book contents
- Frontmatter
- Contents
- Acknowledgements
- Preface
- List of abbreviations
- Section I Musculoskeletal radiology
- Achilles tendonopathy/rupture
- Aneurysmal bone cysts
- Ankylosing spondylitis
- Avascular necrosis – osteonecrosis
- Femoral-head osteonecrosis
- Kienböck's disease
- Back pain – including spondylolisthesis/spondylolysis
- Bone cysts
- Bone infarcts (medullary)
- Charcot joint (neuropathic joint)
- Complex regional-pain syndrome
- Crystal deposition disorders
- Developmental dysplasia of the hip (DDH)
- Discitis and vertebral osteomyelitis
- Disc prolapse – PID – ‘slipped discs’ and sciatica
- Diffuse idiopathic skeletal hyperostosis (DISH)
- Dysplasia – developmental disorders
- Enthesopathy
- Gout
- Haemophilia
- Hyperparathyroidism
- Hypertrophic pulmonary osteoarthropathy
- Irritable hip/transient synovitis
- Juvenile idiopathic arthritis
- Langerhans-cell histiocytosis
- Lymphoma of bone
- Metastases to bone
- Multiple myeloma
- Myositis ossificans
- Non-accidental injury
- Osteoarthrosis – osteoarthritis
- Osteochondroses
- Osteomyelitis (acute)
- Osteoporosis
- Paget's disease
- Perthes disease
- Pigmented villonodular synovitis (PVNS)
- Psoriatic arthropathy
- Renal osteodystrophy (including osteomalacia)
- Rheumatoid arthritis
- Rickets
- Rotator-cuff disease
- Scoliosis
- Scheuermann's disease
- Septic arthritis – native and prosthetic joints
- Sickle-cell anaemia
- Slipped upper femoral epiphysis (SUFE)
- Tendinopathy – tendonitis
- Tuberculosis
- Tumours of bone (benign and malignant)
- Section II Trauma radiology
Rickets
from Section I - Musculoskeletal radiology
Published online by Cambridge University Press: 22 August 2009
- Frontmatter
- Contents
- Acknowledgements
- Preface
- List of abbreviations
- Section I Musculoskeletal radiology
- Achilles tendonopathy/rupture
- Aneurysmal bone cysts
- Ankylosing spondylitis
- Avascular necrosis – osteonecrosis
- Femoral-head osteonecrosis
- Kienböck's disease
- Back pain – including spondylolisthesis/spondylolysis
- Bone cysts
- Bone infarcts (medullary)
- Charcot joint (neuropathic joint)
- Complex regional-pain syndrome
- Crystal deposition disorders
- Developmental dysplasia of the hip (DDH)
- Discitis and vertebral osteomyelitis
- Disc prolapse – PID – ‘slipped discs’ and sciatica
- Diffuse idiopathic skeletal hyperostosis (DISH)
- Dysplasia – developmental disorders
- Enthesopathy
- Gout
- Haemophilia
- Hyperparathyroidism
- Hypertrophic pulmonary osteoarthropathy
- Irritable hip/transient synovitis
- Juvenile idiopathic arthritis
- Langerhans-cell histiocytosis
- Lymphoma of bone
- Metastases to bone
- Multiple myeloma
- Myositis ossificans
- Non-accidental injury
- Osteoarthrosis – osteoarthritis
- Osteochondroses
- Osteomyelitis (acute)
- Osteoporosis
- Paget's disease
- Perthes disease
- Pigmented villonodular synovitis (PVNS)
- Psoriatic arthropathy
- Renal osteodystrophy (including osteomalacia)
- Rheumatoid arthritis
- Rickets
- Rotator-cuff disease
- Scoliosis
- Scheuermann's disease
- Septic arthritis – native and prosthetic joints
- Sickle-cell anaemia
- Slipped upper femoral epiphysis (SUFE)
- Tendinopathy – tendonitis
- Tuberculosis
- Tumours of bone (benign and malignant)
- Section II Trauma radiology
Summary
Characteristics
Rickets is inadequate mineralisation of osteoid in the immature skeleton.
Osteomalacia (softened bone) is the same inadequate mineralisation of bone, but occurring in the adult skeleton without the growth disturbances of rickets.
Rickets occurs secondary to vitamin D deficiency/dysfunction, and with inadequate intake of calcium and phosphorus.
Associated with sunlight deficiency, renal disease, liver disease and malabsorption, because of the effect on vitamin D synthesis.
Clinical features
Infants may present with convulsions, tetany or failure to thrive.
Craniotabes (skull deformity) develops early.
Muscular hypotonia is common.
Wrist, ankle and knee swelling.
‘Rickety rosary’ – costochondral junction enlargement.
Harrison's sulci – lateral chest-wall gutters secondary to muscular action on weakened ribs.
Leg bowing and knock-knees become more prominent on weight bearing.
Spinal involvement and long-bone fractures are late manifestations.
Radiological features
Metaphyses of long bones subjected to stress are particularly involved (wrists, ankles, knees).
Irregular widened epiphyseal plates – due of the failure of mineralisation.
Cupping and fraying of metaphyses – best seen where growth is maximal.
Coarse trabecular pattern.
Long-bone bowing.
Periosteal reaction may be present.
Management
Identify and treat underlying cause.
Most deformities will correct with growth once the condition is treated.
Corrective surgery for severe deformities may be required.
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- A-Z of Musculoskeletal and Trauma Radiology , pp. 127 - 128Publisher: Cambridge University PressPrint publication year: 2008