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Rickets: Historical, Epidemiological, Pathophysiological, and Pathological Perspectives.

Alfredo Walker1, Dina El Demellawy2, Jorge Davila3

  • 1Eastern Ontario Regional Forensic Pathology Unit - Department of Pathology and Laboratory Medicine - University of Ottawa.

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|June 27, 2019
PubMed
Summary
This summary is machine-generated.

Vitamin D deficiency (VDD) causes rickets, a preventable bone disease. Despite past eradication efforts, VDD remains a global issue in children, with distinct radiological and histological signs.

Keywords:
Forensic pathologyImmunomodulationRadiological findingsRicketsVDDVitamin D deficiency

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Area of Science:

  • Pediatric metabolic bone disease
  • Nutritional deficiencies
  • Radiology and Histopathology

Background:

  • Rickets, primarily due to Vitamin D deficiency (VDD), was historically prevalent but largely controlled by public health measures.
  • Despite preventive strategies, VDD persists as a global health concern in children, affecting even developed nations.
  • VDD is the most common, entirely preventable, and treatable metabolic bone disease.

Purpose of the Study:

  • To review rickets from historical, pathophysiological, radiological, and histological perspectives.
  • To highlight the persistent global health challenge of VDD in children.
  • To present a case study of rickets in an infant.

Main Methods:

  • Review of historical data on rickets prevalence and prevention.
  • Analysis of characteristic radiological features of VDD-induced rickets.
  • Examination of distinctive histological findings in rickets related to impaired bone mineralization.

Main Results:

  • Radiological signs include metaphyseal cupping/fraying, poor epiphyseal mineralization, widened growth plates, and periosteal reactions.
  • Histological features show disordered chondrocyte proliferation, loss of columnar arrangement, and impaired cartilage resorption.
  • A case of rickets incidentally found in a premature infant is presented.

Conclusions:

  • Rickets due to VDD remains a significant, preventable pediatric health issue.
  • Distinctive radiological and histological findings are crucial for diagnosis.
  • Continued vigilance and preventive measures are necessary to combat VDD globally.