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

Ans. is 'b' i.e., Hypothyroidism o Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism. X-ray findings of hypothyroidism o Delayed appearance of epiphysis o Multiple foci of ossification --) Epiphyseal dysgenesis o Epiphyseal breaking of 12th thorasic and 1st or 2nd lumber veebrae. o Skull --> i) Large fontanelle ii) Wide sutures iii) Wormian bones iv) Enlarged & rounded Sella turcica o Delayed dentition