Nutritional Rickets in a Pediatric Athlete Presented With Left Wrist Pain: A Rare Occurrence

Abstract

The case report aims to describe nutritional rickets in a professional pediatric gymnast with wrist pain. This 13-year-old professional national gymnast presented with atraumatic left wrist pain. The X-ray showed metaphyseal plate tearing, indicating distal radial epiphysiolysis and subsequent testing revealed low 25-hydroxyvitamin D (42 nmol/L), high serum parathyroid hormone (7.37 pmol/L), normal calcium (2.24 mmol/L), elevated phosphate (1.37 mmol/L), and alkaline phosphatase (259 U/L). She was diagnosed as nutritional rickets. MRI of the wrist showed metaphyseal plate fraying and epiphyseal growth plate increase. She received calcium and vitamin D supplements. After a month in a wrist brace, she gradually resumed training as her pain and range of motion improved. Vitamin D deficiency can cause unusual rickets presentation in a young athlete. Clinical, blood, and radiographic findings determine diagnosis. Medical management, graded rehabilitation, nutritional intervention, and sun exposure are the main treatments for this athlete.