The prominent knobs of bone at the

costochondral joint The costochondral joints are the joints between the ribs and costal cartilage in the front of the rib cage. They are hyaline cartilaginous joints (i.e. synchondrosis or primary cartilagenous joint). Each rib has a depression shaped like a cup t ...

s 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 sem ...

, hence the name by analogy with the beads of a Catholic Christian rosary.

Causes

Causes include:
-
- * 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

or other causes of calcium deficiency such as

hypoparathyroidism Hypoparathyroidism is decreased function of the parathyroid glands with underproduction of parathyroid hormone (PTH). This can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany (involuntary m ...

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