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RADIOLOGY IN RICKETS
Dr Priya Chudgar.
Lecturer in Radiology,
Department of Radiology,
KEM Hospital,
Mumbai.
 

Q: What is rickets?

A: Rickets is a disease caused by deficiency of Vitamin D leading to bony deformities and hypocalcemia.

Q: Discuss pathophysiological basis of radiographic findings in Rickets.

A: Loss of orderly maturation and mineralization of cartilage cells at the growth plate resulting from Vitamin D deficiency is 'Rickets'. Thus, Rickets is like osteomalacia in a growing skeleton.

Inherent to all rachitic syndromes are osteomalacic changes in portions of skeleton that contains mineralized bone (Mature bone-both compact & spongy).

The skeletal effects are due to lack of calcification of osteoid. The most obvious change are at 'metaphysis'- where rapid growth is occurring. First change to appear is a 'loss of normal zone of provisional calcification' adjacent to metaphysis. This begins as an indistinctness of the metaphyseal margin, progressing to a 'frayed' appearance with widening of the growth plate, due to lack of calcification of metaphyseal bone. Weight bearing & stress on uncalcified bone gives rise to 'splaying' & 'cupping' of metaphysis. A similar but less marked effect occurs in subperiosteal layer , which may cause lack of distinctness of cortical margin.Eventually a generalized reduction in bone density is seen. In the epiphysis - there may be some haziness of cortical margin. Thus all findings in Rickets occur due to failure of calcification & abnormal demineralization.

 
 
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