پاورپوینت ریکتز در کودکان و تاثیر بیماری های گوارشی در متابولیزم استخوان (pptx) 55 اسلاید

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بسم الله الرحمن الرحیم ریکتز در کودکان و تاثیر بیماری های گوارشی در متابولیزم استخوان Rickets Normal bone growth and mineralization require adequate calcium and phosphate, the two major constituents of the crystalline component of bone. Deficient mineralization can result in rickets and/or osteomalacia. Rickets refers to deficient mineralization at the growth plate, as well as architectural disruption of this structure. Osteomalacia refers to impaired mineralization of the bone matrix. Rickets and osteomalacia usually occur together as long as the growth plates are open. Only osteomalacia occurs after the growth plates have fused Clinical Manifestations Skeletal findings Extra-skeletal findings  Radiographic findings  Laboratory findings  Skeletal Findings   Delayed closure of the fontanelles. Parietal and frontal bossing. Craniotabes (soft skull bones). Enlargement of the costo-chondral junction visible as beading alongthe antero-lateral aspects of the chest (the "rachitic rosary“) Harrison groove formation at the lower margin of the thorax. (muscular pull of the diaphragmatic attachments to the lower ribs) Widening of the wrist and bowing of the distal radius and ulna. Progressive lateral bowing of the femur and tibia Radiographic findings (A) Note the widening, cupping, and fraying of the distal radius (arrowhead) and ulna metaphyses with an associated increase in the thickness of the growth plate (arrow). (B) Normal. Radiograph of the hand of a healthy 3-year-old child, without rickets. Rachitic Rosary Chest radiograph of a patient with rickets, demonstrating a "rachitic rosary". Observe the opaque, bulbous indentations of the lung adjacent to the enlarged costochondral junctions (arrows). Vitamin D deficiency rickets in a child Characteristic findings of rickets in children often include radiographic evidence of decreased mineralization around the epiphyses and bowing of the lower extremities. Bow-legs in rickets Bilateral, symmetric bowing of the femurs and tibias