Referred for low vitamin D3 and calcium levels.
X-rays of the pelvis, lower limbs and the left hand
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Generalized decreased bone density, with poor mineralization of both femoral epiphyses, is noted.
Widening of the growth plate with metaphyseal cupping and fraying of all the lower limbs and left wrist bones.
Bilateral fracture lines involving the fibular diaphysis bilaterally.
This is a 1-year-old boy referred with low calcium and vitamin D3 levels. An x-ray of the body was requested to look for signs of rickets. This demonstrated the classical abnormal configuration of metaphyseal "fraying", "cupping" and growth plate widening "splaying". Osteomalacia and bone fractures.