DDX of metabolic bone disease

Approach to the DDX of metabolic bone disease:

  • The most common finding in all types of rickets is widening of the physis and cupping / fraying of the metaphysis
  • In lead poisoning, look for dense metaphyseal bands as well as lead fragments in the bowel
  • Prostaglandin osteopathy should be surveilled for in ductal dependent patients on Prostaglandin E