<prompt> 8 yrs. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is ?RicketsHypothyroidismScurvyHypoparathyroidism  <response>: Ans. is b i.e., Hypothyroidism o Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism. X-ray findings of hypothyroidism o Delayed appearance of epiphysis o Multiple foci of ossification -- Epiphyseal dysgenesis o Epiphyseal breaking of 12th thorasic and 1st or 2nd lumber veebrae. o Skull -- i Large fontanelle ii Wide sutures iii Wormian bones iv Enlarged rounded Sella turcica o Delayed dentition 