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The prominent knobs of bone at the costochondral joints of
rickets Rickets is a condition that results in weak or soft bones in children, and is caused by either dietary deficiency or genetic causes. Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping. Complications ma ...
patients are known as a rachitic rosary or beading of the ribs. The knobs create the appearance of large beads under the skin of the
rib cage The rib cage, as an enclosure that comprises the ribs, vertebral column and sternum in the thorax of most vertebrates, protects vital organs such as the heart, lungs and great vessels. The sternum, together known as the thoracic cage, is a semi ...
, hence the name by analogy with the beads of a Catholic Christian
rosary The Rosary (; la, , in the sense of "crown of roses" or "garland of roses"), also known as the Dominican Rosary, or simply the Rosary, refers to a set of prayers used primarily in the Catholic Church, and to the physical string of knots or ...
.


Causes

Causes include:
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-
* Rickets : Nodularity at costochondral junction (rachitic rosary). * Scurvy : More angular costochondral junction with a sharper step-off (scorbutic rosary) and depressed sternum. * Chondrodystrophy


Pathophysiology

Rachitic rosary is due to a deficiency of calcium resulting in lack of mineralization and an overgrowth of costochondral joint cartilage. The calcium deficiency may be caused by
rickets Rickets is a condition that results in weak or soft bones in children, and is caused by either dietary deficiency or genetic causes. Symptoms include bowed legs, stunted growth, bone pain, large forehead, and trouble sleeping. Complications ma ...
or other causes of calcium deficiency such as hypoparathyroidism.


Diagnosis

Palpation ( Beads formation) , on chest X-ray


Management

Will be present throughout the life (rickets should be treated first)


References

Pediatrics Skeletal disorders Malnutrition Symptoms and signs: musculoskeletal system {{Pediatrics-stub