Rachitic rosary

Rachitic rosary
Rachitic rosary
	Rachitic rosary on chest radiograph

The prominent knobs of bone at the costochondral joints of rickets patients are known as a rachitic rosary or beading of the ribs. The knobs create the appearance of large beads under the skin of the rib cage, hence the name by analogy with the beads of a Catholic Christian rosary.^[1]

Causes

Causes include:^[2]

Rickets : Nodularity at costochondral junction (rachitic rosary).
Scurvy : More angular costochondral junction with a sharper step-off (scorbutic rosary) and depressed sternum.
Chondrodystrophy

Pathophysiology

Rachitic rosary is due to a deficiency of calcium resulting in lack of mineralization and an overgrowth of costochondral joint cartilage. The calcium deficiency may be caused by rickets or other causes of calcium deficiency such as hypoparathyroidism.^[3]

Diagnosis

Palpation ( Beads formation), on chest X-ray

Management

Will be present throughout the life (rickets should be treated first)

References

^ John Little Morris; W.F. Waugh; W.C. Abbott (1900). "Rickets". The Alkaloidal Clinic. 7 (1). Clinic Publishing Company. The earliest bone lesion that we find in incipient rickets is the beading of the ribs, the so-called rachitic rosary. This is due to an enlargement of the osteo chondric articulations, and hence its name because of fancied resemblance to the rosary used by the Catholic worshiper.
- "Rachitic rosary". TheFreeDictionary. Retrieved 12 August 2013.
^ von Schulthess, Gustav K.; Ch.L. Zollikofer, eds. (2005). Musculoskeletal diseases : diagnostic imaging and interventional techniques. 37th International Diagnostic Course in Davos (IDKD) Davos, April 2–8, 2005 : including the Pediatric Satellite course "Kangaroo" Davos, April 2–3, 2005. Milan: Springer. ISBN 8847003180.
- Ebel, Klaus-Dietrich; et al., eds. (1999). Differential diagnosis in pediatric radiology. Stuttgart: Thieme. ISBN 9783131081315.
- Ebel, Klaus-Dietrich; et al., eds. (1999). Differential diagnosis in pediatric radiology. Stuttgart: Thieme. ISBN 3131081317.
^ Munns, Craig F.; et al. (2016). "Global Consensus Recommendations on Prevention and Management of Nutritional Rickets". The Journal of Clinical Endocrinology and Metabolism. 101 (2). Oxford University Press: 394–415. doi:10.1210/jc.2015-2175. PMC 4880117. PMID 26745253.

[1] John Little Morris; W.F. Waugh; W.C. Abbott (1900). "Rickets". The Alkaloidal Clinic. 7 (1). Clinic Publishing Company. The earliest bone lesion that we find in incipient rickets is the beading of the ribs, the so-called rachitic rosary. This is due to an enlargement of the osteo chondric articulations, and hence its name because of fancied resemblance to the rosary used by the Catholic worshiper.
- "Rachitic rosary". TheFreeDictionary. Retrieved 12 August 2013.

[Schulthess2005-2] von Schulthess, Gustav K.; Ch.L. Zollikofer, eds. (2005). Musculoskeletal diseases : diagnostic imaging and interventional techniques. 37th International Diagnostic Course in Davos (IDKD) Davos, April 2–8, 2005 : including the Pediatric Satellite course "Kangaroo" Davos, April 2–3, 2005. Milan: Springer. ISBN 8847003180.
- Ebel, Klaus-Dietrich; et al., eds. (1999). Differential diagnosis in pediatric radiology. Stuttgart: Thieme. ISBN 9783131081315.
- Ebel, Klaus-Dietrich; et al., eds. (1999). Differential diagnosis in pediatric radiology. Stuttgart: Thieme. ISBN 3131081317.

[3] Munns, Craig F.; et al. (2016). "Global Consensus Recommendations on Prevention and Management of Nutritional Rickets". The Journal of Clinical Endocrinology and Metabolism. 101 (2). Oxford University Press: 394–415. doi:10.1210/jc.2015-2175. PMC 4880117. PMID 26745253.

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v t e Signs and symptoms relating to movement and gait
Gait	Gait abnormality CNS Scissor gait Cerebellar ataxia Choreic gait Festinating gait/Parkinsonian gait Magnetic gait Marche à petit pas Propulsive gait Stomping gait Spastic gait Truncal ataxia Vestibular gait Muscular Myopathic gait/Waddling gait Trendelenburg gait Pigeon gait Foot drop Steppage gait Toe walking Asymmetric gait Leaping gait Asynchronous gait Gunslinger's gait Hemiparetic gait Limp Antalgic gait Deformity Lotus gait
Coordination	Ataxia Cerebellar ataxia Dysmetria Dysdiadochokinesia Pronator drift Dyssynergia Sensory ataxia Asterixis Abasia Hemimotor neglect
Abnormal movement	Athetosis Chorea Tremor Fasciculation Fibrillation Myokymia Myoclonus Hyperkinesia / Hypokinesia Myotonia / Pseudomyotonia Hypotonia Stereotypy Akathesia Echopraxia Echolalia
Posturing	Abnormal posturing Stooped posture Camptocormia Osteoporosis Opisthotonus Spasm Trismus Cramp Tetany Hypertonia Joint locking Catalepsy Waxy flexibility Grimacing Tonic immobility
Paralysis	Flaccid paralysis Periodic paralysis Spastic paraplegia Spastic diplegia Spastic paraplegia Syndromes Monoplegia Diplegia / Paraplegia Hemiplegia Triplegia Tetraplegia / Quadruplegia General causes Upper motor neuron lesion Lower motor neuron lesion Sleep paralysis
Weakness	Hemiparesis Gowers' sign Locomotive syndrome Ptosis
Range of motion	Contracture Bethlem sign Club foot Joint stiffness Ankylosis Hypermobility Gorlin sign EDS HSD Boutonniere deformity Swan neck deformity Scoliosis Kyphosis
Other	Rachitic rosary Flat feet Overpronation/Flexible flat feet Knock-knee Bow-leggedness Back knee Hyporeflexia Hyperreflexia Clasp-knife response Shivering Hypnic jerk Astasia-abasia Vertigo Motion sickness Conversion disorder Shell shock Stupor Catatonia Dancing mania