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A 6-year-old Indian girl presented with progressive bowing of both legs for the last 4.5 years (figure 1). She was diagnosed as having rickets by her primary care physician and was treated with multiple courses of vitamin D, without effect. Her immediate postnatal history and developmental milestones (language, social and motor) were normal and she started walking without support at 1 year. She had been breast fed exclusively until 6 months and was on an age-appropriate average Indian non-vegetarian diet with adequate milk intake. The deformity was associated with neither muscular weakness, myalgia, carpopedal spasm nor failure to thrive. Clinical examination revealed severe short stature (height SD score:−3.5) with an upper segment: lower segment ratio of 1.4:1. She was obese (weight: 32 kg; height: 94 cm; body mass index: 36.2 kg/m2 (>97th centile)) with no stigmata of hypercortisolism/hypothyroidism or Albright's hereditary osteodystrophy. Her head circumference was normal with no frontal bossing; she had no widening of wrists or ankles, no prominent costochondral junction and no dental anomalies. Figure 1 Child with bowing of both legs. Baseline …