This Issue's Rounds Question -
Please tell us:
What is a sequestrum?

(responses to be published in next issue)

In the last issue of Body Cast, Rounds asked: What is meant by the term Rachitic Rosary?
The following responses were received:

From Earl Oborowsky and Angela Wentzell:
A Rachitic Rosary is the name given to the characteristic appearance of the costochondral joints in severe rickets. They are palpable and sometimes visibly enlarged.

From Mary-Jane Buchner:
The term Rachitic Rosary refers to the enlargement of the costochondral junctions. It is typically found on patients with rickets disease. They are prominent knobs of bone at the costochondral joints. It is also referred to as beading of the ribs because it creates an appearance of large beads under the skin. In rickets, they are rounded knobs that form at the joints. With scurvy, they are flat depressions. It can also cause your sternum to become more prominent and that is referred to as pigeon chest. As for treatment, it would appear that it's the same as treating rickets.

From Gary Marshall and Lynne Pizzale:
A Rachitic Rosary is the name given to the characteristic appearance of the costochondral joint in severe rickets. They are palpable and sometimes visibly enlarged. The knobs create the appearance of large beads under the skin of the rib cage, hence the name by analogy with the beads of a rosary.
Rickets is a disorder primarily caused by lack of vitamin D, calcium or phosphate, which leads to softening and weakening of the bones.

From Tom Yorke:
Rachitic: of, or relating to, or affected by rickets. Resembling or suggesting the condition of one suffering from rickets disease.

The prominent knobs of bone at the costochondral joints of rickets are known as Rachitic Rosary or beading of the ribs. The knobs create the appearance of large beads under the skin of the rib cage, thus the name by analogy with the beads of a rosary.

Costochondral joints are articulations between the false ribs and costal cartilage. They are hyaline cartilaginous joints. Each rib has a depression shape like a cup that a costal cartilage articulates with. There is normally no movement at these joints. Joints between costal cartilages of ribs six to nine are plane synovial joints, and articulations between costal cartilage of ribs nine and 10 are fibrous.
Rickets or rickets disease is a medical condition that softens the bones. It is a childhood condition caused by a vitamin D deficiency. This lack in vitamin D results in weak, soft bones, along with slowed growth and skeletal development. Rickets is a disorder that begins in childhood. If this problem occurs later in life, it is known as Osteomalacia.

Osteomalacia is adult rickets.

Responses were also received from: R. Aceron, D. Brown, L. Burk, J. Cannon, J. Carragher, F. Carrozza, E. Christiansen, R.I.F. Chun, D. Edwards, A. Gibbs, M. Gillingham, R. Grenier, S. Groulx, M. Lash, B. Lavallee, C. Longphee, L. MacDonald, B. Matheson, J. Maulucci, J. Movasseli, J. Pike, B. Rawlings, V. Robichaud B. Sheppard, A. Tarambikos, N. Yao, M. Walker, and H. Wong.