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Images in paediatrics
Wormian bones: thinking beyond osteogenesis imperfecta
  1. Rebecca Kylie Halligan1,
  2. Leanne Royle2,
  3. Claire Lloyd2,
  4. Roshni Vara1,
  5. Moira Shang-Mei Cheung3
  1. 1 Paediatric Metabolic Medicine, Evelina London Children's Hospital, London, UK
  2. 2 Paediatric Radiology, Evelina London Children's Hospital, London, UK
  3. 3 Department of Paediatric Endocrinology, Evelina London Children's Hospital, London, UK
  1. Correspondence to Dr Rebecca Kylie Halligan, Paediatric Metabolic Medicine, Evelina London Children's Hospital, London SE1 7EH, UK; bec.halligan{at}

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A term infant was noted to have scalp swelling and widened fontanelles. A skull X-ray on day 14 revealed multiple wormian bones (MWB), which was attributed to vitamin D deficiency and managed with cholecalciferol. He re-presented at 4 months with seizures, developmental delay, sparse hair, white sclera and failure to thrive. Chest X-rays revealed healing right posterolateral 5th–7th rib fractures and subtle expansion of the anterior ribs (figure 1). He had …

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  • Contributors RKH wrote the case synopsis and LR collated the images. CL, RV and MS-MC contributed to the editing of the synopsis and image.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.