Type Differentiation of Rickets

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The term "rickets" or "osteomalacia" may be only significant of a syndrome just as rheumatism, in which the excess of osteoid seam is formed by disturbed calcium deposition to newly formed bone. It is absolutely important to differentiate the type of rickets, as the treatment and the prognosis in each type is different one another.There are some processes in diagnosis as follows.1) As for history, present illness and clinical signs, some characteristics are found in relation to the aetiology.The diagnosis is commonly done by x-ray findings and determinations of calcium, inorganic phosphorus and alkaline phosphatase activity in the serum.2) In x-ray findings, changes which represent secondary hyperparathyroidism may develop in some types of rickets, especially in glomerular osteodystrophy.In addition, some marked radiological findings may also be shown in idiopathic hypophosphatemic osteomalacia. These findings, however, can not be useful in distinguishing the types.3) The histological changes such as excess of osteoid, bone resorption, fibrosis and new bone formation, as well as much retained calcium following to calcium infusion can make sure of the diagnosis.4) The most significant information of type differentiation is given from the biochemical findings and the functional tests of the related organs.5) Existence of secondary hyperparathyroidism can be confirmed from calcium infusion and EDTA disodium calcium infusion tests.6) As the biochemical determination does not demonstrate significant difference between Vitamin D deficient rickets and hypophosphatemic rickets, the observation of response to treatments is definite in those cases.
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Type Differentiation of Rickets

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