True about vit – D deficiency rickets –
Correct Answer: X-ray knee joint is diagnostic
Description: Ans. is 'b' i.e., X-ray knee joint is diagnosticTreatment of Vit D deficiency rickets o There are two stagies for administration of vitamin D ?A) Stagy 1 (stoss regimen) 6 lac IU (15,000 g or 15 mg) Vit D3 is administered every 2 weekly. At every follow up monitoring is done by X-rays and blood investigations. Once healing is staed, children are fuher put on 400 IU or 10 g of vitamin B3 per day.B) Stagy 2 2,000 - 5,000 IU (50 - 125 g) of vit D3 is given every day for 4-6 weeks.Radiological changes of Rickets o Earliest radiological changes are seen around the wrist, i.e. at lower end of radius & ulna.o Later on, similar changes may also be seen around knee, elbow & ankle.o X-ray findings are - Cupping & flaring of metaphysis Large gap between epiphysis and metaphysis because of widening of physis (growth plate). Fraying of metaphysis due to irregular calcification at metaphyseal margins. Generalized osteopenia Coical thinning Coarse & fuzzy trabeculation White line of calcification (frenkels line) at physeal region ---> It is the first radiological sign of healing and appears after administration of Vit D.About other optionso Rachitic rosary is nontender (in contrast rosary of scurvy, i.e. scorbutic rosary is tender).o Softening of ribs impairs air movement and predisposes patient to chest infection (pneumonia) and atelectasis. o Hyponatremia may be seen in rickets due to renal tubular acidosis (not in Vit D deficiency rickets).
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