X-rays wrist showed fraying but no cupping. Investigations showed Ionized calcium level 1.627mol/l (normal-1.12-1.23mmol/l), 24 hour urine calcium 420 mg/ day, serum phosphorus 2.9gm/dL, serum alkaline phosphatase 2820 IU, and vitamin D3 level 18.88 ng/mL (normal 11.1-42.9 ng/mL). Abdomen ultrasound showed cystitis. Tubular reabsorption of phosphate was 92 (Max 100min-82). ABG pH was normal. Ul...

BACKGROUND Primary hyperparathyroidism (PHPT) is uncommon among children with an incidence of 1:300,000. This diagnosis is often missed in children in contrast to adults where it is detected at a pre symptomatic stage due to routine blood investigations. Etiology of PHPT can be due to adenoma, hyperplasia or rarely carcinoma. CASE PRESENTATION A 12 year old Sri Lankan girl presented with prog...

Hydrofluorosis is a major public health problem in India, which is aggravated by presence or absence of some minerals in water or food. Fluoride by itself or in combination with other elements like molybdenum (Mo) in diet or water changes excretion/retention of bone minerals. Sorghum and pearl millet grown and consumed in fluorosis endemic areas contained significantly higher amounts of Mo than...

Isolated lateral compartment arthritis or focal chondral defects in the setting of genu valgum young, active individuals can be treated with a varus-producing distal femoral osteotomy without cartilage treatment. Both medial closing-wedge and opening-wedge techniques have been described, neither demonstrating clear superiority. The objective this Technical Note is to describe technique biplanar...

A 71-year-old woman presented at the outpatient clinic for the first time in 1973 with diffuse bone pain mainly in both wrists, shoulders and the spine. Clinical examination showed limb deformities (genu varum of the left leg, genu valgum of the right leg) and short stature (142 cm). At that time, she had already experienced multiple spontaneous fractures of the right and left femur. There was ...

Gonarthrosis in the relatively young and active population causes major daily discomfort and disability. If the arthritic process is mainly limited to the medial compartment, the axis of a varus knee can be realigned laterally with high tibial osteotomy to unload the medial compartment and allow some cartilage regeneration and pain relief. This study describes the outcomes of patients who under...

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Wilson's disease is most common disorder of cooper metabolism. It has varied clinical presentations. We report a 12 years old female child presenting with genu valgum progressed over 6 months. Careful examination, high index of suspicion and investigations confirmed Wilson's disease.