<prompt> A 10-year-old boy has a fracture of femur. Biochemical evaluation revealed Hb 11.5 gmdL and ESR 18 mm 1st hour. S. calcium 12.8 mgdL, S.phosphorus 2.3 mg dL alkaline phosphate 28 KA units and blood urea 32 mgdL. Which of the following is the most probable diagnosis in his case:Nutritional ricketsRenal ricketsHyperparathyroidismSkeletal dysplasia  <response>: Blood investigations reveal normal ESR, hypercalcemia, hypophosphatemia and raised ALP levels with normal B.urea- Hyperparathyroidism can give rise to this picture. Renal rickets- S. phosphate is high S. calcium lownormal with deranged kidney functions. Nutritional rickets- S.phosphate and calcium can be normal or low but never high . Skeletal dysplasia- abnormal bone cailage are seen, but blood levels of calcium phosphorus are usually normal. 