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Rickets — DCH MCQ

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HardGrowth and nutritionRicketsDCH

A 16-month-old has delayed walking, bowed legs and wrist widening. He is breastfed, takes little vitamin D, and bloods show low phosphate with raised alkaline phosphatase. What is the most likely diagnosis?

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Correct answer: E — Nutritional rickets

Delayed walking with bony deformity and biochemical changes in a child with low vitamin D intake suggests nutritional rickets. Osteogenesis imperfecta usually presents with fractures and other connective tissue features rather than this biochemical pattern. The pearl is to ask about supplementation, diet and sun exposure.

Reference: NICE CKS Vitamin D deficiency; BNFc