Primary hypophosphatemic rickets: an uncommon cause of bowed legs

This paper describes a 9-year-old girl with primary hypophossphatemic ricketts, an uncommon cause of bowed legs. A simple screening for patients presenting with bowed legs is suggested and the importance of using age-related standards for comparison of biochemical results is emphasized (AU)

Vitamin-D deficiency rickets in Jamaican children

Vitamin-D deficiency is not as rare in Jamaica as previously believed. 9 children with vitamin-D deficiency rickets have been seen at the University Hospital of the West Indies during the past 5 years. All were over 3 years of age at time of presentation. Both dietary deficiency of vitamin-D and lack of exposure to sunlight seem to be important causes. Children living in rural Jamaica seem to be more susceptible to the disease than those living in a city, due perhaps to more prolonged breast feeding and lack of fortified milk feeds on weaning.(AU)

Unusual cases of rickets - abstract

Four unusual cases of rickets presented at the Orthopaedic Clinic, University Hospital of the West Indies, with deformity of long bones. It was assumed at first that these were cases of vitamin D resistant rickets, rickets due to renal dysfunction, or malabsorption syndrome. Nutritional rickets was not considered since this occurs only when the child is not exposed to sunlight and there is a deficiency of fresh fruit and vegetables. This type of rickets occurs in infancy where the diet may be very limited. The children seen at the Orthopaedic Clinic ranged between the ages of 4 to 14 years, and presented with florid rickets. Blood chemistry revealed slightly low calcium, low phosphorus and elevated alkaline phosphatase. No abnormality was discovered in renal function tests and in the faecal excretion of fats. While the patients were being investigated, and without any treatment, the rickets healed, clinically and radiologically, on a normal ward diet. The rickets remained healed after the child returned to its previous environment. It appears therefore, that a type of nutritional rickets can occur in older children and in the presence of an abundance of sunlight. The aetiology of this nutritional rickets remains obscure (AU)

Non-rachitic bow leg and knock-knee deformities in young Jamaican children

Severe bow legs and knock knees are very common in Jamaican children. These two deformities are closely related and are not due to any known pathological condition including rickets. In advanced cases the bow legs change to tibia vara and the knock knees to tibia valga, while changes appear in the tibial metaphysis which resemble osteochondritis radiologically. Three factors, racial, eccentric pressure on the knee and increased plasticity of bone, have been shown to play a part in the development of these deformities. In severe bow legs treatment appears to be indicated when the angle formed by the femur and tibia exceeds 25 deg. Spontaneous correction of lesser angulation can occur (Summary)

Hypercalcaemia with features resembling rickets in five female siblings

A study was made of an Indian family in Trinidad in which five sisters were similarly affected with an abnormality involving mainly the lower limbs and showing radiological features of rickets. The limb deformities became apparent between 2-4 years of age soon after they started to walk. Three brothers and a sister have not so far shown evidence of this abnormality. Four of the sisters have had raised serum calcium and alkaline phosphatase levels and have shown gradual improvement in the bony deformity without any special treatment (AU)

Osteopetrosis associated with rickets and scurvy

A case of Albers Schonberg disease complicated by subclinical rickets and scurvy is described. This combination in a negro child has not been previously described (Summary)

Rickets in Jamaica

Florid rickets occuring in twins in Jamaica is described. Reasons are given for considering the rickets to be" simple". Although the patients were grossly malnourished, the most important causative factor is thought to be lack of sunlight. (AU)