title: A reliable and cost effective approach for radiographic monitoring in nutritional rickets.
abstract: OBJECTIVE
  Radiological scoring is particularly useful in rickets, where pre-treatment radiographical findings can reflect the disease severity and can be used to monitor the improvement. However, there is only a single radiographic scoring system for rickets developed by Thacher and, to the best of our knowledge, no study has evaluated radiographic changes in rickets based on this scoring system apart from the one done by Thacher himself. The main objective of this study is to compare and analyse the pre-treatment and post-treatment radiographic parameters in nutritional rickets with the help of Thacher's scoring technique.
  
  
  METHODS
  176 patients with nutritional rickets were given a single intramuscular injection of vitamin D (600 000 IU) along with oral calcium (50 mg kg(-1)) and vitamin D (400 IU per day) until radiological resolution and followed for 1 year. Pre- and post-treatment radiological parameters were compared and analysed statistically based on Thacher's scoring system.
  
  
  RESULTS
  Radiological resolution was complete by 6 months. Time for radiological resolution and initial radiological score were linearly associated on regression analysis. The distal ulna was the last to heal in most cases except when the initial score was 10, when distal femur was the last to heal.
  
  
  CONCLUSIONS
  Thacher's scoring system can effectively monitor nutritional rickets. The formula derived through linear regression has prognostic significance.
  
  
  CONCLUSIONS
  The distal femur is a better indicator in radiologically severe rickets and when resolution is delayed. Thacher's scoring is very useful for monitoring of rickets. The formula derived through linear regression can predict the expected time for radiological resolution.
authors.affiliation: Department of Orthopaedics, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
authors.forename: D
authors.initials: D
authors.lastname: Chatterjee
authors.forename: V
authors.initials: V
authors.lastname: Gupta
authors.forename: V
authors.initials: V
authors.lastname: Sharma
authors.forename: B
authors.initials: B
authors.lastname: Sinha
authors.forename: S
authors.initials: S
authors.lastname: Samanta
mesh_terms: D000328:Adult; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002118:Calcium / Q000008:administration & dosage; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods; D011446:Prospective Studies; D011859:Radiography; D012279:Rickets / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014457:Ulna / Q000000981:diagnostic imaging; D014807:Vitamin D / Q000008:administration & dosage; D014955:Wrist Joint / Q000000981:diagnostic imaging
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium