You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is 8 years. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is – and explain in detail?
Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism.

X-ray findings of hypothyroidism 

Delayed appearance of epiphysis
Multiple foci of ossification → Epiphyseal dysgenesis
Epiphyseal breaking of 12th thoracic and 1st or 2nd lumbar vertebrae.

Skull → 

Large fontanelle
Wide sutures
Wormian bones
Enlarged & rounded sella turcica


Delayed dentition