Toddler with Isolated Motor Delay and Rickets

Excerpt

To the Editor: A one-and- a half-year-old boy presented with complaints of delayed walking. He was born to a non-consanguineous couple with a normal perinatal period. He attained standing with support a few days before the presentation, however, was not able to walk independently. Language and social milestones were normal. His family history was non-contributory. On examination he had frontal bossing, open anterior fontanelle, Harrison sulcus, and bilateral wrist and ankle widening. Neurological examination showed mild hypotonia with preserved muscle stretch reflex. Radiographs of the bilateral wrist and ankle showed generalized osteopenia, and cupping, fraying and splaying of the metaphysis of long bones. …