Uploaded July 2026 | Updated September 2026, 1 week ago
A 6-month-old baby boy was transferred to a quaternary children’s hospital for evaluation and management of seizures. One week earlier, he had had decreased oral intake, vomiting, and irritability. Laboratory testing showed hypocalcemia, hypophosphatemia, and microcytic anemia. Radiography of the left hand and wrist to evaluate hypocalcemia is shown. What is the most likely diagnosis? Submit your answer at NEJM.org/image-challenge.
A 6-month-old baby boy was transferred to a quaternary children’s hospital for evaluation and management of seizures. One week earlier, he had had decreased oral intake, vomiting, and irritability. Laboratory testing showed hypocalcemia, hypophosphatemia, and microcytic anemia. Radiography of the left hand and wrist to evaluate hypocalcemia is shown. What is the most likely diagnosis? Submit your answer at NEJM.org/image-challenge.
