Vitamin D deficiency rickets simulating child abuse.

This paper describes a 2 1/2-year-old Bengali child who presented with failure to thrive and was found to have several fractures of the extremities. The skull radiographs showed widening of the sutures and fracture-like appearances. However, there was no evidence of a subdural haematoma. Minor rachitic changes were at first disregarded, and he was assumed to have been neglected and to have sustained nonaccidental injury. He was discharged to foster parents. It was eventually recognised that the skeletal changes were all appearances of rickets and that some of the fractures were in fact pseudofractures. The child returned to his own parents at the age of 4. Malnutrition, a well known consequences of rickets, may make interpretation of radiographs of the epiphyses difficult.