ODOQuiz - One Day One Question

01 September 2025

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Here you see two children with bony deformities (Fig. A and B). One is common and the other is rare
1. Describe the clinical findings

RICKETS
Common for both: skeletal abnormalities, but they have different underlying causes and characteristics
Cause: Vitamin D, calcium or phosphate deficiency
Predominantly skeletal problems.
Predominant skeletal deformities involving limbs
Rickets can often be reversed with proper nutrition, vit D, Ca, PO4

MORQUIO
Common for both: skeletal abnormalities, but they have different underlying causes and characteristics
Cause: Genetic mutation - deficiency in specific enzymes
Morquio - wider range of symptoms affecting multiple organs, the heart, lungs, and eyes.
Short stature, spinal deformities (kyphosis, scoliosis), joint problems, heart and lung involvement, corneal clouding, hearing loss, and intellectual development
Morquio disease is a progressive, genetic condition, enzyme replacement therapy as a treatment option.

2. Radiological findings A,B,C,D?

RICKETS Radiological
X-rays: Widening of physis, shown by the yellow arrow
Proximal ends of the metacarpals normal Vertebra normal

MORQUIO - Radiological
X-rays: No widening of physis. (white horizontal arrows) Metaphyseal irregularity present
Proximal ends of metacarpals are bullet-shaped (compared with those of rickets)
Middle constriction retained (like normal)
Middle beaking of the vertebra

3. Biochemical findings?

RICKETS
Biochemical: Vitamin D levels low, serum ca and phosphorous – normal low, Alkaline PO4 ase high

MORQUIO
Biochemical: Vitamin D, serum calcium, phosphorous and Alkaline PO4 ase - Normal