What does protrusion of lower ribs indicate in a child?

Q: My three years old daughter’s left part of the lower rib is a little protruded. But she does not have any pain or any other problem. We took her to a doctor who told us that it is due to lack of Vitamin D. Please guide.

A:Protrusion of lower ribs can be a sign of rickets, a condition that results from deficiency of vitamin D. However this needs to be confirmed with an X-ray of wrist of the child that shows characteristic changes of rickets. Also, it would require some lab investigations. Once confirmed rickets needs treatment and follow-up to see response to therapy.