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患儿女,3岁。因2年来双下肢弯曲而就诊。患儿孕、产、家族史无特殊。生长发育正常。查体:体重13kg,身高82cm、头围50cm。角膜KF环阴性。双膝关节内翻,呈“O”形腿。膝间距为10cm,肋骨串珠、手镯征、下肋外翻较显见。心、肺、腹部、神经系统物理检查均正常。实验室检查:血常规、血气、血沉、类风湿因子均正常。尿常规正常,血钙2.2mmol/L,血磷1.2mmol/L,AKP25u。X线:双膝关节、胫、股骨均呈内翻畸形,内侧骨皮质增厚,胫骨内侧干骺端呈鸟嘴状改变,密度不匀,双侧股骨内侧干骺端不规则向内伸展。腕、脊柱片正常。无明确佝偻病样表现。本例有典型胫骨外翻的临床及X线表现,且无佝偻病的血生化及骨骼改变,故可诊断此病。
Children with children, 3 years old. Two years due to lower limb flexion and treatment. Children with pregnancy, birth, family history no special. Growth and development of normal. Physical examination: weight 13kg, height 82cm, head circumference 50cm. Corneal KF ring negative. Double knee varus, was “O” -shaped legs. Knee spacing of 10cm, ribs beaded, bracelet sign, lower eversion more obvious. Heart, lung, abdomen, nervous system physical examination were normal. Laboratory tests: blood, blood gas, ESR, rheumatoid factor were normal. Urinary routine normal blood calcium 2.2mmol / L, phosphorus 1.2mmol / L, AKP25u. X-ray: Both knees, tibia and femur showed varus deformity, medial cortical thickening, medial tibial metaphyseal beak-like changes, uneven density, bilateral medial femoral metaphyseal irregular inward stretch. Wrist, spinal column normal. No clear rickets disease-like performance. This case has a typical tibial valgus clinical and X-ray findings, and no rickets blood biochemical and bone changes, it can diagnose the disease.