What radiographic features are characteristic of rickets in children?

• A. Metaphyseal cupping/fraying and widening of growth plates with bone deformities.
• B. Looser zones and pseudofractures.
• C. Diffuse osteopenia.
• D. Subperiosteal bone formation.

Answer: (B)

In rickets the growth plates are failing to mineralize properly, so the pictures of growing bones show problems at the metaphyses. The hallmark radiographic finding is metaphyseal cupping and fraying with widening of the growth plates, often accompanied by bowing or other bone deformities as the child bears weight. These changes reflect defective endochondral ossification at the physis.

Looser zones are vertical or transverse radiolucent lines that indicate pseudofractures, a feature more typical of osteomalacia in adults than of pediatric rickets. Diffuse osteopenia can occur with nutritional deficiency but does not define rickets, and subperiosteal bone formation is not characteristic of the disease in children.