6th February 2024

A 5-year-old African female has recently migrated with her mother as an asylum seeker.

A 5-year-old African female has recently migrated with her mother as an asylum seeker. Her mother reports coming from a low socioeconomic status. She is worried that her daughter’s growth is slower than expected when compared to her son. 

Examination reveals that her child is below the 5th percentile for height and weight. She had an abnormal gait with bowing of her tibia/fibula and femur. X-rays showed a widening of the metaphyseal ends with increased flaring of the metaphysis and bowing of the femur and tibia. Blood tests show low calcium and phosphate levels. 

What is the underlying diagnosis?