Paediatric Orthopaedics · NEET PG Preparation Orthopaedics
An 18-month-old child is brought to the orthopaedics outpatient department with bilateral intoeing and bowing of the legs. On examination, there is p…
Practice question from Paediatric Orthopaedics (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-86E97B
An 18-month-old child is brought to the orthopaedics outpatient department with bilateral intoeing and bowing of the legs. On examination, there is physiological genu varum, but the intercondylar distance is 8 cm, and wrists show widening and metaphyseal cupping and fraying on radiographs. Serum calcium is low-normal, serum phosphate is low, and alkaline phosphatase is markedly elevated. Which of the following is the pathognomonic histological finding in the growth plate of this condition?
- A.Disorganized columnar arrangement of chondrocytes with unmineralized osteoid accumulationCorrect answer
- B.Premature closure of the epiphysis due to avascular necrosis
- C.Hypertrophy of the resting zone without changes in the proliferative zone
- D.Replacement of bone marrow elements by fibrous connective tissue
Solution
The clinical and biochemical findings are characteristic of nutritional rickets (Vitamin D deficiency rickets). Histologically, rickets is characterized by failure of mineralization of the growth plate cartilage and newly formed osteoid, leading to a disorganized columnar arrangement of chondrocytes, widening of the hypertrophic zone, and accumulation of unmineralized osteoid.
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