Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Due to chronic renal dysfunction.
Renal tubular defects result in a loss of calcium and phosphate in the urine leading to children with deficient mineralization of growing bone and rickets.
Renal glomerular defects inhibit phosphate excretion and Vitamin D activity in resorbing calcium which leads to high serum phosphate and low serum calcium which leads to secondary hyperparathyroidism. Glomerular defects can complicate end stage tubular defects. Skeletal changes occur after a few of months in infants but may require a few years to show up in older children.
The radiographic changes of rickets include uncalcified osteoid which leads to widening of the growth plate, loss of the zone of provisional calcification, metaphyseal cupping, flaring, and irregularity.
Radiographic changes of secondary hyperparathyroidism include subperiosteal bone resportion and demineralization. The resorption is most commonly seen in the phalanges / distal radius and clavicles / ribs / symphysis pubis / SI joints /femoral necks. Osteosclerosis is related to secondary hyperparathyroidism and results in generalized increased bony density. It may also be seen in a localized form is the spine where "rugger jersey" spine can be seen due to sclerosis of the vertebral body endplates.
See References Chapter.
Section Top | Title Page
Follow us on Twitter @pedseducation and @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2015 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.