This is best seen when comparing knee and wrist radiographs in the same patient. These patients also may demonstrate a generalized bone modeling error resulting in short, squat bones. With a renal tubular cause of rickets, the radiographic picture can be very confusing, since one often has overlapping findings of osteomalacia and secondary hyperparathyroidism. This overlap is sometimes referred to as renal osteodystrophy. Vitamin D metabolism Vitamin D metabolism is a slightly more complex topic.
Humans produce Vitamin D in their skin following exposure to ultraviolet light.
We also obtain it from dietary sources or vitamin supplements. It is then hydroxylated by the liver to form 25 OH D, which circulates, bound to a specific binding protein. Or, we could give them liver or kidney disease, and interrupt the process a bit further down the chain. Well, it can be tricky. Some findings, such as osteopenia or coarsening of the trabeculae, are very nonspecific, and not helpful for diagnosis.