ArticleRadiology2012
Rachitic changes, demineralization, and fracture risk in healthy infants and toddlers with vitamin D deficiency.
Article in Radiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Serum 25-hydroxyvitamin D threshold and risk of rickets in young children: a systematic review and individual participant data meta-analysis to inform the development of dietary requirements for vitamin D.European journal of nutrition · 2024Pooled it
- Vitamin D-A Risk Factor for Bone Fractures in Children: A Population-Based Prospective Case-Control Randomized Cross-Sectional Study.International journal of environmental research and public health · 2023Trial
- Trial
- Article
- Multi-modality imaging characteristics of costochondral fractures, a highly specific rib fracture for child abuse.Pediatric radiology · 2022Article
- Comparison of 25-OH vitamin D levels between children with upper and those with lower extremity fractures: A prospective case-control study.Acta orthopaedica et traumatologica turcica · 2022Article
- Evolving forensic controversies in child abuse imaging.Pediatric radiology · 2021Review
- Vitamin D, rickets and child abuse: controversies and evidence.Pediatric radiology · 2021Review
- [Diagnostic Imaging for Physical Abuse in Children].Taehan Yongsang Uihakhoe chi · 2020Review
- Rachitic change and vitamin D status in young children with fractures.Skeletal radiology · 2020Observational
- Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect.Dermato-endocrinology · 2017Article
- Are There Hallmarks of Child Abuse? I. Osseous Injuries.Academic forensic pathology · 2016Review
- Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation.Journal of clinical research in pediatric endocrinology · 2016Article
- The etiology and significance of fractures in infants and young children: a critical multidisciplinary review.Pediatric radiology · 2016Review
- Vitamin D and skeletal health in infancy and childhood.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Review
- ‘Keller & Barnes’ after 5 years — still inadmissible as evidence.Pediatric radiology · 2013Article
- Increasing incidence of nutritional rickets: a population-based study in Olmsted County, Minnesota.Mayo Clinic proceedings · 2013Article
- Rickets: Part II.Pediatric radiology · 2013Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo examine radiographic findings in children with vitamin D deficiency in comparison with biochemical marker levels and prevalence of fractures. MATERIALS AND
methodsThe parents or guardians of all participants provided written informed consent at the time of enrollment. The institutional review board approved the protocol, and HIPAA guidelines were followed. From a prospective sample of children seen for routine clinical care, 40 children with vitamin D deficiency (25-hydroxyvitamin D [25-OHD] level, ≤ 20 ng/mL) were identified, and high-detail computed radiographs of the wrists and knees were obtained. The children ranged in age from 8 to 24 months. Radiographs were scored by three readers with use of the 10-point Thacher score for rachitic changes and a five-point scale for demineralization. Serum calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels were determined. Fracture history was obtained for 35 of the 40 patients (88%).
resultsAll readers identified rachitic changes at both readings in two patients (5%) and demineralization in two patients (5%). Interrater agreement was 65% for rachitic changes (κ = 0.33) and 70% for demineralization (κ = 0.37). When the majority of the raters determined that rachitic changes were absent at both readings, alkaline phosphatase levels were lower than those with other assessments (median, 267 vs 515 U/L [4.4589 vs 8.6005 μkat/L]; P = .01). When most raters determined that demineralization was present at both readings, serum 25-OHD levels were lower than those at other assessments (median, 9.0 vs 17.5 ng/mL [22.464 vs 43.68 nmol/L]; P = .02). No fractures were reported or identified radiographically.
conclusionIn infants and toddlers with vitamin D deficiency, rachitic changes and definite demineralization are uncommon and fracture risk is low.
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