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Concave distal end of ulna metaphysis alone is not a sign of rickets

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Abstract

Background

Statements have been made in the literature and in legal testimony that misrepresent the radiographic finding of concave distal end of the ulnar metaphysis.

Objective

To demonstrate that a concave distal end of the ossified ulna in infancy can be normal.

Materials and methods

Eighty distal wrists of randomly selected infants in the first year of life with radiographic evidence that ruled out rickets were reviewed.

Results

In 16 of the cases (20%), mild or moderate concavity of the distal end of the ulna was seen. An intact metaphyseal collar of distal radius or ulna confirmed the absence of radiographic rickets.

Conclusion

The finding of 20% of concave distal ulnas in the first year of life confirms the widely acknowledged statements that concave distal end of the ulna alone is not indicative of rickets. Statements to the contrary are not justified.

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Conflicts of interest

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Authors and Affiliations

  1. Department of Radiology, 5031, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229-3039, USA

    Alan E. Oestreich

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  1. Alan E. Oestreich
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Correspondence to Alan E. Oestreich.

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Oestreich, A.E. Concave distal end of ulna metaphysis alone is not a sign of rickets. Pediatr Radiol 45, 998–1000 (2015). https://doi.org/10.1007/s00247-014-3268-6

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  • DOI: https://doi.org/10.1007/s00247-014-3268-6

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