A 36 month old girl shows frontal bossing and wrist enlargement. Diagnosis is -

Ans. is 'a' i.e., RicketsClinical features of ricketso Clinical manifestations of rickets are usually manifested by 6 months of age. Rickets is unusual below the age of 3 months.Clinical features of rickets are :o Skull: Craniotabes (earliest manifestation), frontal and parietal bossing; widened sutures; delayed closure of anterior fontanel; Caput quadratum or hot cross-bun skull; soft skull with ping-pong ball like feelo Chest: Rachitic rosary (prominent costochondral junction); pectus craniatum (pigeon breast); Harrison's groove (horizontal depression along lower border of chest corresponding to insertion of diaphragm)o TeathDelayederuption;enamelhypoplasia;dentalcaries.o Limbs and joints : Bone pain & tenderness (most common manifestation); coxa vara; genu valgus) or genu varus; bowing of legs (tibia), femur, radus & ulna; widening of wrist, elbow, knee & ankle; windswept deformity; string-of-pearls deformity (Saucage-like enlargement of ends of phalanges and metacarpals with constrictions at joints); double malleoli sign (two medial malleoli are palpable instead of one).