Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with concerns regarding skeletal deformities, delayed motor milestones, and generalized irritability. History significant for limited sunlight exposure and inadequate dietary vitamin D/calcium intake. Reports of bone pain, muscle weakness, and frequent fractures. No history of malabsorption syndromes or chronic renal disease.
Clinical Examination Findings
Physical exam reveals frontal bossing, craniotabes, and delayed closure of fontanelles. Thoracic examination shows rachitic rosary and Harrisonโs groove. Extremities demonstrate bowing of the long bones (genu varum/valgum) and widening of the wrists and ankles. Patient exhibits hypotonia and a waddling gait.
Treatment Protocol
Initiate high-dose Vitamin D3 (cholecalciferol) supplementation as per clinical protocol. Ensure adequate dietary calcium intake (dairy or supplements). Monitor serum levels of 25-hydroxyvitamin D, calcium, phosphorus, and alkaline phosphatase. Orthopedic consultation requested for severe skeletal deformities.