PT  - JOURNAL ARTICLE
AU  - Fida, Nadia M.
TI  - Assessment of nutritional rickets in Western Saudi Arabia
DP  - 2003 Apr 01
TA  - Saudi Medical Journal
PG  - 337--340
VI  - 24
IP  - 4
4099  - http://smj.org.sa/content/24/4/337.short
4100  - http://smj.org.sa/content/24/4/337.full
SO  - Saudi Med J2003 Apr 01; 24
AB  - OBJECTIVE: To explore the role of radiological examination and certain biochemical values in diagnosis and assessing severity of nutritional rickets.METHODS: Cases of symptomatic nutritional rickets (age range between 3-36 months) seen at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia, during the period 1997-1999 were studied. Clinical examination by the author of the study, determination of calcium (Ca), phosphate (PO4), alkaline phosphates (ALP), hand and wrist x-rays, were performed for all cases.RESULTS: Sixty cases of nutritional rickets were diagnosed within 2 years (incidence of 0.5%), 38.3% of the patients presented with swollen wrist and 28.3% with bowleg. The bone profile at time of diagnosis: Ca = 2.33 +/- 0.23, PO4 = 1.47 +/- 0.40 and ALP = 925 +/- 418. Approximately 81.7% of the patients had normal Ca level, 18.3% had low serum PO4 level, 98.3% showed high value of ALP. X-ray studies indicated that, 58.3% of patients had active rickets, 35% had minimal changes, and 6.7% showed healed rickets. Among those having active rickets 20% had low PO4 level, 83% had normal Ca value, and 100% had high ALP. The mean value +/- SD of biochemical values in this group: Ca = 2.34 +/- 0.24, PO4 = 1.45 +/- 0.42, ALP = 1067 +/- 452. The later was significantly higher compared to other groups (P=0.004) but no significant differences were observed between mean values of other parameters.CONCLUSION: Radiological examination and ALP remains essential to confirm clinical diagnosis of rickets and assessment of severity.