Muhammad Shahzeb, Waqas Ali, Zahid Iqbal.
Radiographic Scoring Method for Assessment of Severity of Nutritional Rickets.
Ophthalmol Update Jan ;16(2):695-8.

Aims: To get to know about severity of nutritional rickets through radiographic scoring method. Methods: A cross sectional hospital based study was done on 60 children of age under 10-15 without specification of gender with clinical signs of rickets. All the patients were underwent x-rays to find the radiographic changes for severity of rickets. The severity was calculated by the scores which were based on the radiographic changes. Study was undertaken in the Radiology department of general hospital Lahore . A10 points scoring method was applied to measure the severity of rickets by the radiographic changes of the wrists and knees such as cupping, metaphyseal fraying and degree of growth plate affected. According to the scoring method, changes in the radius and ulna were graded according to the presence of fraying and irregularity of metaphyseal margins and the degree of concave cupping. Results; The mean radiographic score was found to be 6.86. Then according to the scoring 6 out of 60 presented with mild rickets. 22 out of 60 presented with moderate rickets and 31 out of 60 presented with severe rickets. Conclusion: It is concluded that limited sunshine exposure as individuals spend more time indoors watching television and working on computers or intentional sunshine avoidance for prevention of skin cancer Traditional clothing (covered dress) further limits the exposure to sunshine and thus decreases the endogenous synthesis of vitamin D. Supplemental doses of vitamin D required to achieve a serum 25-hydroxyvitamin D level of at least 20 ng/ml (50 nmol/l), the serum concentration that is needed to optimize absorption of dietary calcium, suppress excess secretion of parathyroid hormone, and reduce fracture risk as well as prevent long-term negative effects.

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