Nutritional rickets and malnutrition are common problems in developing countries. We evaluated the radiological parameters in malnourished and also well-nourished children with active rickets and investigated their response to vitamin D treatment. The study population consisted of 99 children with rickets, aged 3–30 months and of this number 73 were malnourished and 26 were well-malnourished. The patients were treated with a single dose of 300 000 IU of vitamin D and oral calcium, intramuscularly. In addition, malnourished children were nutritionally rehabilitated. Radiographic evaluation was performed by using X-rays of the wrist and knee. Radiographic scoring method defined by Thacher et al was used for the assessment of the severity of the nutritional rickets that was observed.
No statistically significant difference in the radiological scores among the three groups of malnourished children and the well-nourished children with rickets was observed. However, radiological scores for all groups of patients decreased significantly at the 12th week after treatment. The initial radiographic scores of rickets correlated with serum alkaline phosphatase (ALP) concentrations. Radiological evidence and the healing process were similar in both the well-nourished and malnourished groups with rickets. We also recommend that radiological follow-up duration should be extended to at least 12 weeks.