PURPOSE: A defect in a phosphate-regulating gene leads to the most common form 
of rickets: X-linked hypophosphatemic rickets (XLH) or vitamin D-resistant 
rickets (VDDR). XLH has been associated with craniosynostosis, the sagittal 
suture being the most commonly involved.
METHODS: We present three patients with rickets and symptomatic sagittal suture 
craniosynostosis all of whom presented late (>2 years of age). Two had a severe 
phenotype and papilledema, while the third presented with an osseous bulging 
near the anterior fontanel and experienced chronic headaches.
RESULTS: All underwent successful cranial vault expansion.
CONCLUSIONS: Rachitic patients with scaphocephaly should be screened for 
craniosynostosis.