Q: My daughter is 1 year and 11 months old. From the past few days we have noticed a slight bend in her left leg. We informed her paediatrician and he suggested to go for x-ray of both knees (AP and Lat). The x-ray report says: inner breaking seen at lower end of femur and upper ends of tibia; fragmentation seen at inner aspects of lower epiphyses of femoia and joints spaces look normal. We consulted an orthopaedic surgeon who told us that, at present it is not a cause of worry as the child is very small. It can be said only after 3 years of age. He has suggested the following: exposure to the sun light; crytacal syrup- 3 1/2 ml twice daily for 90 days; oil message; blood for calcium, phosphorus and others after six months. Is there any cause of worry at this stage? What should we do?

A:Your child most probably is having vitamin D deficient rickets, most likely due to nutritional deficiency. The diagnosis needs to be confirmed by radiographs, blood work-up and clinical examination. Once proved, the condition is amendable to medical treatment and does not require any surgery. The response to treatment needs to be properly followed up by investigations again. Keep a follow-up with your doctor.