Rickets LSBU

Description: Radiology case 458-571 Clinical presentation: 3 year old child of recent immigrants from India, not walking properly.
There is a varus deformity of both legs with bowed tibiae. The epiphyseal plates are widened and all the metaphyses are broad and irregular, relative to the epiphyses. Additionally, the distal tibial metaphyses appear cupped around the epiphyses and there is widening of the low density zone below the zone of provisional calcification. The tibial upper metaphysis is crossed by a line from overlying soft-tissue. There is no visible fracture, but the medial side of both upper tibial and lower femoral metaphyses is irregular and is beaked, where it extends medially. There is some blurring of trabecular detail. There is no visible sub-periosteal resorption of bone.