• Metaphyseal cupping and fraying
  • Widened epiphyses
  • Osteopenia
  • Bowing deformities

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Bulbous enlargement of the anterior costochondral junctions forming a rachitic rosary. There is also generalized osteopenia and metaphyseal splaying of the proximal humeri.
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DDX Tibial Bowing

  • Blount’s disease
  • Neurofabromatosis (anterior, pseudoarthroses)
  • Thanantophoric Dwarfism (telephone receivers)
  • Skeletal Dysplasia (FD, OI)
  • Vitamin deficiency or resistance to Vit D (hypophosphatemia)
  • Congenital Pseudoarthroses of the tibia

DDX Frayed Metaphyses CHARMS

  • Congenital infection (Rubella, Syphillis)
  • Hypophosphatemia (Vit D resistance Rickets)
  • Achondroplasia
  • Rickets
  • Metaphyseal Dysostosis
  • Scurvy
These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.