STATIC AND DYNAMIC BONE CHANGES IN HOSPITALIZED-PATIENTS SUFFERING FROM RICKETS - A HISTOMORPHOMETRIC STUDY

Aims: The aim of this study was to assess static and dynamic bone chan ges in patients suffering from rickets, Methods and results: Transcort ical iliac crest biopsies of 15 hospitalized children with rickets wer e taken after labelling new bone formation with two cycles of tetracyc line administration 10 days apart, Undecalcified sections were prepare d, appropriately stained and histomorphometric analysis performed, Sta tic and dynamic bone changes were measured including the volume of bon e and osteoid, trabecular and cortical bone dimensions and resorptive and mineralization activities, The results were compared with normal v alues, The nature of the mineralization fronts was noted. Trabecular o steoid volumes of all but one patient nas above the normal range of 1. 9% (+/-0.41%). This patient suffered rickets associated with the Kwash iorkor-Marasmus syndrome, Tetracycline labelling was found to be more sensitive than subjective evaluation of the nature of the mineralizati on fronts. Despite a balanced hospital diet, a bone formation rate of zero was found in three cases, indicating a need for vitamin D and min eral supplementation, Seven cases had decreased mineralization lag tim es, indicating response to the balanced diet, Conclusions: This study showed that histometric analysis of labelled bone biopsies is a helpfu l adjunct to the diagnosis but particularly assessment of response to management of deficiency states in children.