8 years. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is –
Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism.

X-ray findings of hypothyroidism 

Delayed appearance of epiphysis
Multiple foci of ossification → Epiphyseal dysgenesis
Epiphyseal breaking of 12th thoracic and 1st or 2nd lumbar vertebrae.

Skull → 

Large fontanelle
Wide sutures
Wormian bones
Enlarged & rounded sella turcica


Delayed dentition
Rickets
Hypothyroidism
Scurvy
Hypoparathyroidism