Secondary prevention of vitamin D-deficiency rickets.

Reports of vitamin D-deficiency rickets and its associated morbidity continue among inadequately supplemented, dark-skinned breastfed infants. Despite the new vitamin D dietary guidelines, there remain significant numbers of unsupplemented breastfed infants. Here we report a case of subclinical vitamin D-deficiency rickets. This patient had biochemical and radiographic but not clinical evidence for rickets. We propose a new step of screening high-risk infants for subclinical rickets using wrist films paired with 25-hydroxyvitamin D levels.