Not a radiological feature of rickets

Ans. c (Subluxation of epiphysis) (Ref. RRM 6th ed., 156)RICKETS# Faulty mineralization of the bone before the fusion of growth plate, i.e., during enchondral bone growth, is known as RICKETS.# Histo: zone of maturation has an increase in number of maturing cartilage cells with loss of normal columnar arrangement; zone of preparatory calcification does not form; failure of osteoid mineralization also in shafts so that osteoid production elevates periosteum.# Location: Metaphyses of long bones subjected to stress are particularly involved (wrist, ankles, knees)# X-rav features:- Widening and lengthening of growth plate (zone of provisional calcification affected) is earliest radiographic feature of rickets.- Reaction of periosteum may occur - - Indistinct cortex - Coarse trabeculation - Knees + wrists + ankles mainly affected - Rickets- Epiphyseal plates widened + irregular - Tremendous metaphysis (fraying, splaying, cupping) - Spur (metaphyseal) - Additional features: --- * Bowing of long bones* Genu recurvatum* At costochondral junction, epiphyseal widening results in typical 'rachitic rosary'* Frontal bossing* Scoliosis* Slipped capital femoral epiphysis* Triradiate pelvis* Basilar invaginationEducational point:D/d of Frayed Metaphyses# Congenital infections (rubella, syphilis)# Hypophosphatasia # Achondroplasia # RicketsMnemonic: CHARMS# Metaphyseal dysostosis # Scurvy The radiological features of scurvy1)Spurs (Pelkan Spur)Metaphyseal spurs projecting at right angles to axis of shaft2)Subperiosteal hemorrhagesDiaphyseal subperiosteal hematoma with calcification of elevated periosteum is the sure sign of healing (woody-leg)3)Cortical thinning"Pencil-thin" cortex4)Corner sign of ParkeSubepiphyseal infarction or comminution causing mushrooming or cupping of epiphysis5)5)OsteoporosisCharacteristically "ground-glass" osteoporosis6)Rarefaction zone of TrummerfeldMetaphyseal radiolucent zone on shaft side7)White line of FrankelMetaphyseal zone of provisional/preparatory calcification also seen in lead or phosphorus or bismuth poisoning and in healing rickets8)Wimberger's signSclerotic ring seen around the low-density osteopenic epiphysis