0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Picture of the Month

Francis Mimouni, MD; Zulf Mughal, MRCP; Reginald C. Tsang, MBBS; Murray Feingold, MD
Am J Dis Child. 1988;142(2):191-192. doi:10.1001/archpedi.1988.02150020093038.
Text Size: A A A
Published online

Denouement and Discussion 

X-linked Dominant Hypophosphatemic Rickets 

Manifestations  Hypophosphatemic rickets is characterized by a primary defect of the reabsorption of filtered phosphate in the kidney, leading to chronic urinary phosphate wastage. This condition is also characterized by an altered vitamin D metabolism; serum 1,25-dihydroxycholecalciferol concentrations are paradoxically "low" for the degree of hypophosphatemia. Defective mineral metabolism leads to impaired mineralization, affecting both epiphyseal cartilage and osteoid tissue at the endosteal bone surface. Lower limbs are clinically and radiologically more affected by the rachitic process than are upper limbs. In contrast to acquired tumor-induced hypophosphatemic rickets, there is no proximal myopathy. Craniosynostoses have been described as complications of the disease but may be precipitated by treatment with 1,25-dihydroxycholecalciferol.Dentin defects (interglobular dentin) lead to a mottled appearance of the tooth surface. Dental abscesses that are not associated with caries or trauma are frequent complications. As a consequence of abnormal dentin formation, large, tubular

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();