Rickets

RACHITIC ROSARY 

Def
Inadequate mineralisation of bone
Effect on physeal growth nd ossification
Deformity of enchondral skeleton

                 Etio
                 Trick
25 alpha intestine of Calcium nd phosphate.

25.       decreased 25 hydroxylation( liver disease)
Alpha  decreased 1alpha hydroxylation (renal dis.)
Intestine.      Intestinal malabsorption
Calcium.      Calcium deficiency
Phosphate.  Hypophosphatemia

                 Patho.
Inability to calcify intercellular matrix in deeper layers of physis.

CRANIOTABES

                  CF 
Craniotabes skull deformity
Rickety rosary  (costochondral junction enalrgement)
Harrison sulcus ( lateral chest indentation)
Distal tibial bowing

HARRISON SULCUS

                  X ray
Growth plate (thickening +widening )
Meatphysis ( cupping nd widening )
Diaphysis     ( bowing )

                 Biochem
Decrease level of Calcium+ phosphate+25OH D
Increased level ALP
 
                Diagnostic
Calcium phosphate product value <2.4 are diagnostic

                 Tt
Vit d 400-1000 IU /DAY
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