The first radiological sign of healing rickets is the appearance of the healing line, which is a radio opaque line in the epiphysis denoting that the mineralization of the provisional zone of calcification had started, Figure 1. As healing progresses remodeling of bowing deformities occur.
Figure 1.lateral X ray view of both ankles show the healing line, which is a radio opaque line in the epiphysis.
Rickets simply refers to deficient mineralization of the growth plate. Deficiency of normal mineralization is most evident at metaphyseal zones of provisional calcification where there is an excess of non-mineralized osteoid resulting in widening of the growth plate and abnormal cupping of the metaphysis and fraying which is indistinct margins of the metaphysis,Figure 2. That results in weak or soft bones in children with bowing and curved spine.
Figure 2. AP and lateral views x ray of both ankles show active rickets with cupping and fraying of the metaphysis
