Osteochondral beading is seen in deficiency of?

Appeared in: VSSC Nursing Officer - 2021

Explanation

Osteochondral beading is the clinical term for 'rachitic rosary,' a hallmark sign of rickets.
Rickets is a disease of growing bone caused by inadequate mineralization, primarily due to Vitamin D deficiency.
The 'beads' are formed by the expansion and overgrowth of unmineralized cartilage and osteoid at the costochondral junctions.
Vitamin D's role is to regulate calcium and phosphate homeostasis; its deficiency impairs the deposition of these minerals into the bone matrix.

Option A: Vitamin A deficiency is not associated with osteochondral beading.
Option B: Vitamin B6 (pyridoxine) deficiency does not cause the skeletal deformities seen in rickets.
Option C: While Vitamin C deficiency (scurvy) can cause a 'scorbutic rosary,' the beading is characteristically sharper and more angular, unlike the smooth beading of rickets.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of vitamin deficiencies as background academic context rather than a clinical decision trigger.
Recognizing a rachitic rosary during a pediatric physical assessment is a critical nursing skill that points directly to a diagnosis of rickets.
Nurses play a key role in preventing rickets by educating parents on the importance of Vitamin D supplementation for infants (400 IU/day), adequate sunlight exposure, and a diet rich in calcium and Vitamin D.
This finding should prompt a comprehensive nutritional assessment and referral for further management to prevent long-term skeletal deformities like bow legs (genu varum) or knock-knees (genu valgum).

How to Approach the Question

First, identify the key clinical sign in the question: 'Osteochondral beading'.
Recall the medical term for this sign, which is 'rachitic rosary'.
Connect the term 'rachitic' to the underlying disease, which is rickets.
Identify the primary cause of nutritional rickets, which is a deficiency of Vitamin D.
Review the other options to confirm they are incorrect. Pay special attention to Vitamin C, a close distractor, and remember the key differences between a rachitic and a scorbutic rosary (smooth vs. sharp beading).

Concept Tested & Keywords

QZFu8QvjxEKDYxrmvO6cZW

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 447-449

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 pp. 514-516, 513-515

Practise the full VSSC Nursing Officer - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.