Subclinical rickets among children visiting a tertiary care hospital


  • Lakshmi Lakkappa Department of Pediatrics, Chamarajanagara Institute of Medical Sciences, Chamarajanagara, Karnataka, India
  • Roy Ninan Abraham Department Pediatrics, CSI Hospital, Bangalore, Karnataka, India
  • Chirsti D. Savio Department Pediatrics, CSI Hospital, Bangalore, Karnataka, India



Biochemical parameters, Children in tertiary care centre, Subclinical rickets, X ray wrist


Background: Subclinical rickets is the early stage of rickets which can be defined as a state where there are no clinically appreciable changes of rickets but is characterized by biochemical changes which include the following Low or normal calcium, Low phosphorus, raised alkaline phosphatase and Low Vitamin D or raised Parathyroid hormone (PTH) levels. Radiological changes are often subtle to detect in sub clinical rickets. The objective of the present study was to estimate the prevalence of subclinical rickets in the age group 6 weeks to 15 years in tertiary care centre and to study their clinical profile.

Methods: Hospital based Cross sectional study was conducted among 156 children in the age group 6 weeks to 15 years over a period of 1 year at a tertiary care centre in South Bangalore. Evaluation and diagnosis of Subclinical rickets was done using various biochemical parameters such as Calcium, phosphorus and alkaline phosphatase and Wrist X ray.

Results: Overall Prevalence of Subclinical Rickets among the study group was 57 (36.5%). Sub clinical rickets was more common among Females (41.4%). Significant difference was observed in time spent for outdoor activities among children with (7.18±3.2 hrs) and without (9.04±4.4 hrs) subclinical rickets. Vitamin D supplemented group had lower prevalence of Subclinical rickets. 26% of them had Wrist Changes for sub clinical rickets. Significant decrease in Serum calcium and phosphorus was observed between subjects with and without subclinical rickets.

Conclusions: Prevalence of Subclinical Rickets in children aged between 6weeks to 15 years is significantly high. Optimal exposure to sunlight and Vitamin D supplementation can bridge the deficiency gap.


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