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What is Commonest deformity in Rickets is and explain in detail?
Ans. a (Genu valgum). (Ref. Maheshwari, Orthopaedics, 2nd/pg.262)RICKETSFaculty mineralisation of the bone before the fusion of growth plate i.e., during enchondral bone growth, is known as rickets.Pathophysiology# Low levels of vitamin D3 >> reduced calcium absoption >> raised PTH >> increased bone resorption, increased renal reabsorption, increased phosphate excretion >> low bone calcium, low serum phosphate >> decreased mineralization >> rickets# X-ray Features include# Children- Poorly mineralized epiphyseal centers with delayed appearance.- Increased distance between end of shaft & epiphyseal center.- Reaction of periosteum may occur with Indistinct cortex.- Coarse prominent trabeculations with decreased bone density- Epiphyseal plates widening & irregularity (EARLIEST RADIOLOGICAL SIGN)- Fraying, splaying & cupping of metaphysis.- Enlargement of epiphysis at radial end of long bones.- Spur (metaphyseal) projecting at right angles to metaphysis in the cortex.- Deformities like bowing of long bones (genu valgum), genu recurvatum, frontal bossing.- Ricketic rosary, Rachitic pelvis- Harrison's sulcus (constant pulling of diaphragm on soft lower ribs seen at subcostal region)- Delayed eruption of temporary teeth# Infants:- Delayed development, Hypotonia, Craniotabes, and Patent anterior fontanella.