Rickets

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Refusing to use right arm following a fall.

Patient Data

Age: 1 year
Gender: Female
x-ray

Fraying, splaying and cupping of the distal radial and ulnar metaphyses. Widening of the physes. These findings are consistent with rickets. 

There is also evidence of an elbow joint effusion with the posterior fat pad evident. This suggests an occult supracondylar fracture as the cause for the patient refusing to use her arm. 

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