Journal of Bone and Mineral Metabolism

, Volume 27, Issue 4, pp 392–401

Hypophosphatemia: the common denominator of all rickets

Review Article

DOI: 10.1007/s00774-009-0079-1

Cite this article as:
Tiosano, D. & Hochberg, Z. J Bone Miner Metab (2009) 27: 392. doi:10.1007/s00774-009-0079-1


Rickets is a disease of the hypertrophic chondrocytes in the growth plate and is caused by hypophosphatemia—a derived defect in terminal chondrocyte apoptosis. This highlights the critical role of phosphorous in cartilage and bone metabolism. This review shows the role of phosphorous metabolism, transport and function in maintaining phosphorous supply to the growth plate, bone osteoblast and the kidney. Given that phosphorous is the common denominator of all rickets, this review proposes a new classification for the differential diagnosis of rickets, which is based on the mechanisms leading to hypophosphatemia—high PTH activity, high FGF23 activity or renal phosphaturia.


HypophosphatemiaRicketsOsteomalaciaSodium phosphorous transporters

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer 2009

Authors and Affiliations

  1. 1.Meyer Children’s Hospital, Rambam Medical CenterHaifaIsrael
  2. 2.Rappaport Family Faculty of Medicine and Research InstituteTechnion-Israel Institute of TechnologyHaifaIsrael