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[Rickets due to vitamin D deficiency--a reminder]
1Orthopädische Universitätsklinik, Zürich.
Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|November 17, 1992
Summary
Vitamin D deficiency rickets is rare in Switzerland due to supplementation. Diagnosis requires careful screening of children with orthopedic issues, considering family history and supplementation refusal.
Area of Science:
- Pediatrics
- Orthopedics
- Nutritional Science
Background:
- Vitamin D deficiency rickets is now rare in Switzerland due to widespread prophylactic supplementation.
- Clinical suspicion is often low, making diagnosis challenging in routine practice.
Purpose of the Study:
- To outline diagnostic strategies for identifying rare cases of vitamin D deficiency rickets in children presenting with orthopedic complaints.
- To emphasize the importance of considering specific risk factors and diagnostic tools.
Main Methods:
- Clinical assessment of children with gait disturbances, bow-legs, or flat feet.
- Detailed patient history, focusing on nutritional status, vitamin supplementation practices, and family beliefs.
- Selective use of X-ray and laboratory findings for diagnosis.
- Confirmation of diagnosis through therapeutic response to vitamin D treatment.
Main Results:
- Diagnosed cases were primarily in children of East-Mediterranean origin with inadequate nutrition/supplementation or those from families refusing vitamin supplementation.
- Orthopedic surgeons face the challenge of differentiating true rickets from physiological variations in children's gait and foot development.
Conclusions:
- Vitamin D deficiency rickets, though rare, requires vigilant screening in pediatric orthopedic practice.
- Key diagnostic elements include a thorough history of vitamin D prophylaxis and targeted investigations, with treatment response confirming the diagnosis.