The purpose of this paper is to describe a patient with an unclassified disorder of the metaphyses which, because of clinical, radiographic, and microscopic similarity to vitamin D-refractory rickets, was treated with toxic quantities of vitamin D. The resemblance of the metaphyseal lesions in the present case to the rare condition "metaphyseal dysostosis," described in 1934 by Murk Jansen, is discussed.
Report of Case
The patient, a girl 22 months of age, was admitted to the hospital because of waddling gait and deformity of both lower limbs (Fig. 1).The child had weighed 3090 gm. at birth. The pregnancy and delivery had been uncomplicated. Growth and mental and motor development had been normal during infancy. A normal diet had been supplemented by percomorph-liver oil (oleum percomorphum), 10 drops each day, since birth. There had been no symptoms suggestive of renal or gastrointestinal disease. The patient appeared to be well until
EVANS R, CAFFEY J. Metaphyseal Dysostosis Resembling Vitamin D-Refractory Rickets. AMA Am J Dis Child. 1958;95(6):640–648. doi:10.1001/archpedi.1958.02060050644009