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Elderly Woman With Odd Knees

Alzheimer disease prevents this woman from making sense, but she is agitated and groans. When lucid she walks fairly well, but look at her oversized knees. What's the cause?

An 81-year-old woman with Alzheimer disease presents with agitation and a great deal of groaning. When not agitated, she is able to walk surprisingly well although she requires contact guarding. Her medical problems include a seizure disorder perhaps of recent onset, well-controlled on phenytoin. She also has undexplained eosinophilia of 15%.

An image of her knees is at left. They look normal when she is seated but unusual when she stands.

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Answer: B. Rickets

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