Bow legs and wide wrists are characteristic of:

AIIMS Delhi NO-2016

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Delhi NO-2016

Explanation

Rickets is a metabolic disease of growing bones in children, primarily caused by vitamin D and/or calcium deficiency.
The deficiency leads to defective mineralization at the growth plates of long bones.
This results in an accumulation of unmineralized cartilage and osteoid, causing the metaphysis to widen, which is clinically visible as wide wrists and ankles.
The bones become soft and weak, and under the stress of weight-bearing, the long bones of the legs bend, leading to deformities like bow legs (genu varum).

Option B: Osteomalacia is the term for undermineralization of bone in adults, after the growth plates have closed. It causes bone pain and weakness but not the characteristic growth plate deformities like wide wrists or bow legs seen in children.
Option C: Polio (poliomyelitis) is a viral disease affecting the nervous system. It causes muscle paralysis and atrophy, which can lead to limb deformities over time, but it does not cause the primary bone-softening and growth plate widening characteristic of rickets.
Option D: CDH, or Developmental Dysplasia of the Hip (DDH), is a specific problem with the formation of the hip joint. It presents with signs like asymmetric thigh folds, limited hip abduction, or a 'clicky' hip in infants. It is a localized orthopedic issue, not a systemic metabolic bone disease.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical manifestations of rickets in children as background academic context rather than a clinical decision trigger.
Nurses play a key role in identifying children at risk for rickets, such as exclusively breastfed infants without vitamin D supplementation, children with dark skin, and those with limited sun exposure.
Patient education is critical. Nurses should teach parents about the importance of vitamin D and calcium intake, appropriate sun exposure, and adherence to supplementation schedules.
Monitoring growth and developmental milestones is a crucial nursing function. Delays in walking or unusual limb shapes should prompt further investigation for conditions like rickets.

How to Approach the Question

First, identify the key clinical signs presented in the question: 'bow legs' and 'wide wrists'.
Recognize that these are signs of skeletal deformity in a growing child.
Systematically review the options provided and recall the primary pathology of each condition.
Rickets is a disease of defective bone mineralization in children, which directly explains both wide wrists (growth plate widening) and bow legs (soft, bending bones).
Osteomalacia is the adult form, so it won't cause these specific growth-related deformities.
Polio is a neurological disease causing paralysis, not a primary bone disease.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 102-104