8 yrs. old child presents with lethargy multiple epiphyseal breaks, wormian bones with growth retardation and mental retardation Diagnosis is (AIIMS Nov 2014)
o Multiple epiphyseal breaks, wormian bones with lethargy, growth retardation and mental retardation suggest the diagnosis of hypothyroidism.
X-ray findings of hypothyroidism
o Delayed appearance of epiphysis
o Multiple foci of ossification - Epiphyseal dysgenesis
o Epiphyseal breaking of 12th thorasic and 1st or 2nd lumber vertebrae.
i) Large fontanelle
ii) Wide sutures
iii) Wormian bones
iv) Enlarged & rounded sella turcica
o Delayed dentition