Vitamin deficiency in a toddler reluctant to use her arm

Area of Science:

• Pediatrics
• Orthopedics
• Metabolic Bone Disease

Background:

• Limb pain is a common pediatric complaint in emergency departments, typically associated with trauma.
• Differentiating traumatic from atraumatic causes of limb pain is essential for appropriate management.

Observation:

• This report details an unusual case of atraumatic limb pain in a toddler.
• Clinical features and radiographic findings raised suspicion for rickets.

Findings:

• Rickets should be considered in the differential diagnosis of atraumatic limb pain in toddlers.
• Unwitnessed trauma with subtle bony injury not visible on initial X-rays is also a possibility.
• Biochemical assays can confirm the diagnosis of rickets.

Implications:

• Expanding the differential diagnosis for atraumatic limb pain in young children is important.
• Prompt diagnosis and management of rickets can prevent long-term complications.
• This case highlights the need for comprehensive evaluation in pediatric limb pain presentations.