Rickets and osteomalacia in northeast Iran: report of 797 cases

Abstract

ABSTRACTAim: To study the clinical, biochemical and radiographic features of rickets and osteomalacia in north‐east of Iran.Methods: We retrospectively reviewed the medical records of all patients with diagnosis of rickets and osteomalacia during the past 20 years (1986–2006) in the rheumatology outpatient clinic of Imam Reza Hospital, Mashhad, Iran.Results: There were 797 patients (795 female, 2 male). Their ages were between 8–74 years. Most cases were in their second decade of life. The most common clinical findings were: bone pain 96.4%, muscle weakness 81%, abnormal gait 43%, and bone deformity 19.6%. The most common laboratory finding was high serum alkaline phosphatase (92%) followed by hypophosphatemia 54.6%, and hypocalcemia (21%). Radiographic findings were: epiphyseal growth plate alterations 74.4%, osteopenia 63%, ground glass appearance 28.6%, and Looser's zones 26.5%. All except four patients were cured with vitamin D and calcium.Conclusion: Rickets and osteomalacia are common disorders in our region. Females especially in the growing years are often involved. The most common cause of rickets and osteomalacia in our region is vitamin D deficiency probably due to inadequate sun exposure.