Vitamin D Deficiency Rickets

  • Etiology: deficiency of Vitamin D leading to disordered mineralization and ossification of the physes
  • Imaging:
    — Demineralization may precede typical rachitic findings
    — Most evident at metaphyses of fastest growing bones – distal radius + femur + costochondral junctions (rachitic rosary)
    — Disorganized cartilage expands, apparent widening of growth plate, zone of provisional calcification has decreased mineralization / trabeculae fade into the cartilage / irregular margins at the cartilage-bone interface / rim of bone around the physis (metaphyseal cupping), stress from ligament attachments leading to fraying and flared

Radiology Cases of Vitamin D Deficiency Rickets

Radiograph of Vitamin D deficiency rickets
CXR AP (above) shows prominence of the anterior ribs near the costochondral junctions (rachitic rosary). AP and lateral radiograph of the wrist (below) shows cupping of the distal radius and ulna metaphyses.