Wrist X-ray showing changes in<unk> . Mainly cupping is seen here. Chest X-ray showing changes consistent with<unk> . These changes are usually referred to as "rosary beads" of<unk> .<unk>  may be diagnosed with the help of: * Blood tests: * Serum calcium may show low levels of calcium, serum phosphorus may be low, and serum alkaline phosphatase may be high from bones or changes in the shape or structure of the bones. This can show enlarged limbs and joints. * A bone density scan may be undertaken. * Radiography typically show widening of the zones of provisional calcification of the metaphyses secondary to unmineralized osteoid. Cupping, fraying, and splaying of metaphyses typically appears with growth and continued weight bearing. These changes are seen predominantly at sites of rapid growth, including the proximal humerus, distal radius, distal femur and both the proximal and the distal tibia. Therefore, a skeletal survey for<unk>  can be accomplished with anteroposterior radiographs of the knees, wrists, and ankles. Types * Vitamin D-related<unk>  * Vitamin D deficiency * Vitamin D-dependent<unk>  (VDDR) * Type 1: insufficiency in activation * VDDR1A: 25-Hydroxyvitamin D3 1-alpha-hydroxylase deficiency * VDDR1B: CYP2R1 deficiency * Type 2: resistance to calcitriol * VDDR2A: calcitriol receptor mutation * VDDR2B: unknown nuclear ribonucleoprotein interfering with signal transduction * Type 3: excessive inactivation (CYP3A4 mutation, dominant) * Hypocalcemia-related<unk>  * Hypocalcemia * Chronic kidney failure (CKD-BMD) * Hypophosphatemia-related<unk>  * Congenital * Vitamin D-resistant<unk>  * Autosomal dominant hypophosphatemic<unk>  (ADHR) * Autosomal recessive hypophosphatemic<unk>  (ARHR) * Hypophosphatemia (typically secondary to malabsorption) * Fanconi's syndrome * Secondary to other diseases * Tumor-induced osteomalacia * McCune-Albright syndrome * Epidermal nevus syndrome * Dent's disease Differential diagnosis Osteochondrodysplasias, also known as genetic bone diseases, may mimic the clinical picture of<unk>  in regard to the features of bone deformities. The radiologic picture and the laboratory findings of serum calcium, phosphate and alkaline phosphatase are important differentiating factors. Blount's disease is an important differential diagnosis because it causes knee deformities in a similar fashion to<unk>  namely bow legs or genu varum. Infants with<unk>  can have bone fractures. This sometimes leads to child abuse allegations. This issue appears to be more common for solely nursing infants of black mothers, in winter in temperate climates, suffering poor nutrition and no vitamin D supplementation. People with darker skin produce less vitamin D than those with lighter skin, for the same amount of sunlight.
Rickets
Scurvy
Pathergy
Osteomalacia
Basophilia
Fanconi syndrome
Oculocerebrorenal syndrome
Platinosis