A 3-Year-Old Boy Is Evaluated for Delayed Developmental Milestones, Including

A 3-year-old boy is evaluated for delayed developmental milestones, including short stature.  There is no family history of bone conditions.  The family recently immigrated to the United States.  The patient was exclusively breastfed until age 6 months and has since had a varied diet of fruits, vegetables, and meats.  He takes no medications or supplements.  Vital signs are normal.  Physical examination reveals frontal bossing, dental enamel defects, and bilateral, symmetric, bead-like enlargement of the costochondral junctions.  If a histologic examination of the bone is performed, which of the following changes is most likely to be seen in this patient?

A) Apoptotic osteoblasts
B) Enlarged osteoclasts
C) Excessive fibrous tissue replacement
D) Excessive mineralized matrix
E) Excessive unmineralized matrix

Correct Answer:

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