Vitamin D: a poor screening tool for biochemical and radiological rickets

Area of Science:

• Pediatric Orthopedics
• Endocrinology
• Nutritional Science

Background:

• Bone and joint pain, muscle fatigue, and knee deformities are common pediatric complaints.
• Vitamin D deficiency is a widespread concern, particularly in certain demographics and seasons.
• Rickets, a condition of bone softening, can result from severe vitamin D deficiency.

Purpose of the Study:

• To investigate the association between serum 25-hydroxyvitamin D levels and the diagnosis of rickets in children presenting with musculoskeletal symptoms.
• To evaluate the utility of serum vitamin D levels as a screening tool for rickets in pediatric patients.

Main Methods:

• Retrospective analysis of 115 new patients from a Paediatric Orthopaedic Clinic.
• Review of biochemistry databases and case notes from 2010.
• Comparison of serum 25-hydroxyvitamin D levels against normal thresholds and rickets diagnoses.

Main Results:

• 88% of children had below-normal serum vitamin D levels (mean 18.27 mcg/l).
• Winter/spring blood samples showed a statistically significant higher likelihood of deficiency.
• Only 2.61% of patients were diagnosed with radiological rickets, despite widespread low vitamin D.

Conclusions:

• Low serum vitamin D is prevalent in children with vague bone and joint pain but infrequently associated with diagnosed rickets.
• Serum 25-hydroxyvitamin D level is not a suitable screening tool for biochemical or radiological rickets.
• Further research is needed to clarify vitamin D requirements in children.