Abstract
THE EARLIEST accounts of childhood rickets describe thoracic deformities and mention respiratory difficulty in severe cases. 1 A more specific description of the respiratory consequences appears in an early edition of Cecil's 2 text: Thoracic deformities... functional embarrassment which attends severe rickets may actually endanger life. The thoracic cage instead of expanding with each downward excursion of the diaphragm may actually become more constricted;... respiration is rapid and difficult and a relatively mild infection may have a fatal termination. A similar thread runs through the literature of renal osteodystrophy. In the first report of the association of rachitic deformity with renal disease, Lucas 3 tentatively includes curvature of the spine and pigeon chest in the syndrome. Further definition of the entity by Barber 4 dwells on growth retardation, renal dwarfism, and the few photographs accompanying his earlier case reports show, at the most, mild pigeon chest and thoracic margin sulcus.
Published Version
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