Nutritional rickets: correlation between clinical, biochemical and radiological profile

To determine the correlation between clinical manifestations, biochemical and radiological profile in children with nutritional rickets. This is a cross-sectional study conducted at paediatric ward of a private sector health facility, Kutyana Memon Hospital Kharadar Karachi. A total of hundred patients aged 2 to 36 months with clinical suspicion of nutritional rickets were included in the study. A detailed history and examination was done and relevant investigations including serum calcium, phosphate, alkaline phosphatase and X-ray wrist joints were done to confirm the diagnosis. Data was analyzed and presented as percentages and frequencies. There were 63% males and 37% females. Majority of children were between 6 to 18 months of age, [49%] followed by 2-6 months [44%] and 18 to 36 months [07%]. Rachitic rosary was the most frequent clinical feature observed in 87% followed by widening of wrist joints in 76% cases. Serum calcium was low in 90% cases and serum alkaline phosphatase was increased in all patients. Serum phosphate was either low or normal in 44% cases each. Radiological findings were suggestive of rickets in 54% cases. Clinical and Biochemical markers are reliable indicators for diagnosis of nutritional rickets, which is more frequent between 2 to 18 months of age

Infantile osteopetrosis associated with rickets case report

A 9-month-old male infant was diagnosed as malignant autosomal recessive form of infantile osteopetrosis by presence of anemia, thrombocytopenia, hepatosplenomegaly, failure to thrive, visual and hearing loss, and the typical radiological images on plain radiograms. the patient had associated clinical and laboratory findings as a rare presentation

Risk factors in rickets. a case - control study

[a]: To describe the personal, clinical and radiological characteristics of children with rickets. [b]: To measure the strength of association between risk factors and rickets. Design: Case-Control Study. Setting: The study was conducted in the University Hospital of Saddam Medical College and al-Kadhmyia Children Hospital in Baghdad, during the period from June to December 1996. Participants: Two hundred children under the age of 2 years with rickets who attended the out- patient departments of the mentioned two hospitals formed the group of cases. A random sample of 150 children, attending the same departments, for reasons other than rickets, were selected as controls. Intervention: Data on the personal, clinical and radiological characteristics of 200 cases of rickets were ascertained. The cases and controls were compared as to the risk factors of a positive family history of rickets, inadequate exposure to sunlight, bottle feeding, breast feeding and delayed introduction of supplementary feeding. Main Outcome Measures: Relative risk in case-control analysis is estimated by the odds ratio [OR]. The OR, its statistical significance and its 95% confidence interval [CI] are computed to ascertain the strength of association between each risk factor and rickets, by comparing cases with controls. The proportion of males among children with rickets was 45%. About 3/4 of the cases were in the age group 6-18 months, and 12% were under 6 months. Two thirds of their mothers had at least finished primary school education.Two thirds of the children had no more than 4 siblings. Four fifth of the children were born at full-term. Chest infection and diarrhea were the most common presenting features. Widening of the wrists and rachitic rosary were the most frequent clinical signs more than half [57%] of the babies with rickets were at least 1 standard deviation below normal weight for age. The proportion of those below 2 standard deviation was 22%. The ratio of early [grade I] to late [grade III] and advanced [grade Ill] bone changes on radiological examination was 1:1.5 [79:121]. Strongly associated risk factors with rickets, in descending order, were bottle-feeding [OR= 7.2, 95% CI=2.55-18.4], breast-feeding [OR=5.92, 95% CI= 2.75-11.9], delayed supplementary feeding till after 6 months of age [OR=5.77, 95% CI=3.27-9.78], inadequate exposure to sunlight [OR=4.15, 95% CI=2.65-6.4]. Breast feeding and bottle feeding were not significantly different from each other as risk factors in the development of late and advanced bone changes. Bottle feeding, breast feeding, delayed supplementary feeding till after months of age and inadequate exposure to sunlight are very strong risk factors in rickets

[Radiological changes of rickets in children]

RICKETS: Rickets in children in the bone disorders caused by lack of vitamin D.Vitamin D deficiency may occur when there is inadequate intake of vitamin D and insufficient exposure to the ultraviolet rays. It is more likely to occur, however, during periods of rapid growth, and produce the most marked changes in the bones - abnormal bone growth. It is uncommon in tile first 3 months. Our study includes the following: 1 - Studying the clinical findings of rickets. 2 - Studying the laboratory findings. 3 - Studying the X - Ray findings. 4 - Studying the complications and prognosis of rickets. We found that the early diagnosis, sufficient and regular treatment and preventive procedures are of great importance to avoid the undesired complication such as deformities of the limbs.The incidence of rickets in our study was [3.9%] of all diseased children in University Aleppo Hospital