Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
A metabolic bone disease characterized by a failure of normal mineralization of growing bone due to Vitamin D deficiency. Causes of Vitamin D deficiency include nutritional deficits (dietary or lack of sunlight), malabsorption (pancreatic insufficiency, hepatobiliary disease, small bowel disease), renal disease (renal glomerular or tubular disorders),and increased Vitamin D requirement (Vitamin D resistance, anticonvulsant therapy).
On plain film there is characteristic flaring, cupping, expansion and irregularity of the metaphysis. This is because bone matrix or osteoid continues to form but cannot be calcified and the accumulation of this non calcified osteoid results in the irregular appearance of the metaphysis. In severe cases periosteal elevation can be seen. Expansion and fraying of the rib ends is called rachitic rosary.
See References Chapter.
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