Rachitic rosary

Case contributed by Dalia Ibrahim

Presentation

Palpable bony swellings on the chest wall bilaterally

Patient Data

Age: Infant
Gender: Male
x_ray

Widening of the anterior rib ends at the costochondral junctions.

Case Discussion

Rachitic rosary is most frequently seen in rickets (which is the diagnosis in this case)

Differential diagnosis

Other causes of this appearance include: 

  • scurvy
    • costochondral junctions are more angular with sharper step-offs (scorbutic rosary)
    • sternum is usually depressed
  • hypophosphatasia
  • chondrodystrophy
  • healing fractures as a result of non-accidental injury in children: important to consider as an alternative explanation

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