Orthonotes
Orthonotes
by the.bonestories
v3.0 Fusion
v3.0 Fusion
pediatrics topic hub

Rickets — Orthopaedic Sequelae

Failure of mineralization at the growth plate → metaphyseal cupping, fraying, and splaying with genu varum/valgum. Differentiate **nutritional vitamin D deficiency** from **X‑linked hypophosphatemic rickets (XLH)** and renal rickets; labs guide diagnosis. Medical therapy first: vitamin D and calcium for nutritional; **phosphate + active vitamin D** (calcitriol) for XLH; burosumab in select cases. Orthopaedic: guided growth hemiepiphysiodesis for coronal deformity; corrective osteotomy when severe/rigid or after metabolic control. Beware Looser zones (pseudofractures) and bone pain; correct biochemistry pre‑op to improve healing.

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Failure of mineralization at the growth plate → metaphyseal cupping, fraying, and splaying with genu varum/valgum. Differentiate **nutritional vitamin D deficiency** from **X‑linked hypophosphatemic rickets (XLH)** and renal rickets; labs guide diagnosis. Medical therapy first: vitamin D and calcium for nutritional; **phosphate + active vitamin D** (calcitriol) for XLH; burosumab in select cases. Orthopaedic: guided growth hemiepiphysiodesis for coronal deformity; corrective osteotomy when severe/rigid or after metabolic control. Beware Looser zones (pseudofractures) and bone pain; correct biochemistry pre‑op to improve healing.
MCQs

High-yield practice questions

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Question 1

In X-linked hypophosphatemic rickets (XLH), which biochemical finding is typically observed?

Question 2

What is the primary medical treatment for nutritional rickets?

Question 3

Which radiographic sign is characteristic of active rickets?

Question 4

What is the distinguishing biochemical feature of X-linked hypophosphatemic rickets compared to nutritional rickets?

Question 5

What surgical intervention is indicated for severe, rigid coronal deformities associated with rickets?

Question 6

What is the most common orthopedic sequelae of rickets?

Question 7

Which condition is characterized by pseudofractures or Looser zones in adults?

Question 8

Which of the following is true regarding the treatment of X-linked hypophosphatemic rickets?

Question 9

What preoperative biochemical correction is important for improving healing in rickets patients undergoing surgery?

Question 10

Which of the following is the most common cause of rickets worldwide?