8 years. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is –

Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism. X-ray findings of hypothyroidism Delayed appearance of epiphysis Multiple foci of ossification → Epiphyseal dysgenesis Epiphyseal breaking of 12th thoracic and 1st or 2nd lumbar vertebrae. Skull →  Large fontanelle Wide sutures Wormian bones Enlarged & rounded sella turcica Delayed dentition