Chapter-074 Metabolic Bone Disease in Children

BOOK TITLE: ESI Manual of Clinical Endocrinology

1. Khadgawat Rajesh
2. Jevalikar Ganesh
Publishing Year
Author Affiliations
1. All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India
2. Medanta - The Medicity, Gurgaon 122 001, Haryana, India, Medanta Medicity Hospital, Gurgaon, Haryana, India
Chapter keywords
Metabolic bone diseases, skeletal disorders, rickets, calcipenic, phosphopenic, Blount’s disease, hypervitaminosis D, osteoporosis, osteogenesis imperfect


Metabolic bone diseases contain a heterogeneous group of skeletal disorders. Rickets is classified as calcipenic and phosphopenic. Rickets ensuing from vitamin D and calcium deficiency is the most frequent etiology. Clinical features of rickets may differ depending on the severity and duration of VDD and dietary calcium intake. Phosphopenic rickets has some different clinical features from the calcipenic. Blount’s disease commonly seen in obese subjects may present with bowing of legs, similar to rickets. Biochemistry explains normal to low serum calcium. Changes of rickets are best observed in a plain AP radiograph of the wrist and knee. Treatment can be done through preparations of vitamin D, treatment schedule, and calcium supplementation during treatment and duration of therapy. The prevention of rickets consists of maintenance of sufficient vitamin D level of the mothers, supplementation of those at risk of VDD and maintenance of adequate calcium intake at all ages. The treatment with vitamin D should be done cautiously. Similarly hypervitaminosis D, metabolic bone disease of prematurity, osteoporosis in children and osteogenesis imperfect are also explained.

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