In Rickets all are seen except -
Ans. is 'c' i.e., BleedingClinical features of ricketso Clinical manifestations of rickets are usually manifested by 6 months of age.o Rickets is unusual below the age of 3 months.Regional manifestationsSkullCraniotabes (softening of cranial bones)o It is the earliest manifestation of rickets.o Pressure over occipital and parietal bones gives ping pong ball like feel.Frontal bossing - Prominent frontal bones.Parietal bossingWidened suturesDelayed closure of anterior fontanel.Caput quadratum or hot cross - bun skull - The widened suture & thickening of bone around sutures create a cruciate pattern.ChestRachitic rosary - Prominent costochondral junction.Pectus craniatum (pigeon breast) - sternum projects forw ard.Harrison's groove - A horizontal depression along lowrer border of chest corresponding to the insertion of diaphram. It occurs due to pulling of the softened ribs by the diaphragm during inspiration.TeethDelayed eruptionEnamel hypoplasia and dental caries.SpineThoracic kyphosis - Rachitic Cat backAccentuation of lumbar lordosisScoliosis (uncommon)Limbs & jointsBone pain & Tenderness - most common manifestation.Coxa varaGenu valgus or Genu varusBowing of tibia, femur, radius & ulnaWidening of wrist, elbowr, knee & ankle because of enlargement of ends of long bones.Rachitic saber shinsSausage - like enlargements of ends of the phalanges and metacarpals, with regular constrictions corresponding to the joints - string-of-pearls deformity.Windswept deformityDouble malleoli sign ->>on palpation of medial malleoli two malleoli are palpable instead of one.AbdomenAbdomen becomes protuberant - Rachitic pot - belly.This is because of marked hypotonia of abdominal muscles.Systemic manifestationsGrowth retardationApathy, listiessness & irritabilityHypotonia and muscle weaknessLigament laxityTetany, laryngeal stridor and convulsions, when there is hypocalcemia or Alkalosis which predisposes to hypocalcemia.
Bowing of legs
Rachitic Rosary
Bleeding
Craniotabes
Bone