Evaluation and interpretation of residual rickets deformities in adults

Abstract Recent research has considerably improved the recognition and recording of rickets and osteomalacia in archaeological human bone, but the recognition and recording of residual deformities of rickets present in adults is still limited. The aim of this study was to assist with differential diagnosis of residual rickets deformities and determine which of the deformities that are characteristic of rickets could be identified in the adult skeleton. Long bone deformities were investigated, with research focusing on deformities of the leg bones. One hundred and thirty‐five adults from the historic cemetery of St Martin's, Birmingham, where vitamin D deficiency was known to have been widespread, were analysed. Deformities of leg bones were three times as frequent as arm bone deformities, and deformity of both the femur and tibia was the most frequently recorded combination of leg bones. Medial bending of the tibiae and anterior bending of femora, both at the proximal end, were the most frequently recorded types of deformities. A review of a range of conditions that can cause bowing deformities, and comparison of bowing recorded in children with rickets and the present cases, concluded that the most likely cause of the deformities recorded was residual changes linked to rickets. In this community, bowing deformities linked to rickets were quite common amongst adults and probably did not have adverse social consequences, but further studies are required to determine whether this attitude to deformity was more widespread. Copyright © 2008 John Wiley & Sons, Ltd.