Abstract
Background: Rickets is failure in mineralization of growing bone and cartilage due to extreme vitamin D deficiency (VDD). The
study aimed to identify rickets among vitamin D deficient children and determine any relationship between clinical findings and
paraclinical evidence.
Methods: This study was conducted in two stages. In the first stage, blood was drawn from 406 children aged 30–72 months for
measurement of 25(OH)D level. Of these children, 108 had 25(OH)D levels of <20 ng/dL and were evaluated physically for
signs and symptoms scores (0-1) of VDD and rickets. Biochemical analysis and radiography of the child’s left wrist and hand was
performed.
Results: Of the 119 children (29.67%) with 25(OH)D levels of <20 ng/dL, 42 (10.3%) had vitamin D levels of ≤15 ng/dL. There
was no correlation between serum 25(OH)D level and levels of calcium (Ca) (r = −0.16), alkaline phosphatase (ALP) (r = −0.12),
P (r = 0.13), and parathyroid hormone (PTH) (r = −0.15,) in children with VDD. The mean of signs and symptoms scores had no
significant difference between children with (1.59 ± 0.8) and without (1.73 ± 1.01) VDD (P = 0.3). None of the children with VDD
had radiographic evidence of rickets. Radiographic data showed that 69.2% (72), 10.6% (11), and 20.2% (21) of the children had
delayed, normal, and advanced bone age, respectively.
Conclusion: Abnormal radiological findings of rickets were not found on wrist X-rays. Thus, this investigation is not necessary
within the range of vitamin D levels described in the current study.