Rickets Detection: Clinical Signs, Radiographic Findings, and Assessment

Clinical Signs

• Skeletal: Bowing of legs (genu varum/valgum), rachitic rosary (costochondral beading), Harrison’s groove, wrist/ankle widening, craniotabes (soft skull), delayed fontanelle closure.
• Growth: Stunting, delayed motor milestones.
• Muscular: Hypotonia, weakness, bone pain.
• Dental: Enamel hypoplasia, delayed eruption.

Radiographic Hallmarks

• Metaphyseal fraying, cupping, widening
• Provisional zone of calcification blurred
• Diaphyseal osteopenia

Laboratory Findings

• Low 25-OH vitamin D
• Elevated alkaline phosphatase
• Low/normal calcium, low phosphate
• Elevated PTH (secondary hyperparathyroidism)

Assessment

Combine history (diet, sun exposure, malabsorption), physical exam, labs, and imaging. Early diagnosis prevents irreversible deformities.