Koo et al developed a grading system to describe radiographic changes in the long bones of infants with rickets of prematurity. The authors are from the University of New South Wales and the University of Sydney in Australia.
Radiographs: wrists and ankles at 5 and 10 weeks after delivery
Parameters:
(1) cortex of the bone
(2) metaphysis
(3) submetaphysis
(4) fracture
Cortex
Metaphysis
Submetaphysis
Fracture
Grade
normal
dense white line
band of lucency
none
0
thinning
thinning or loss of the dense white line
increased lucency
none
1
thinning
irregular and frayed
splaying and cupping
none
2
NA
NA
NA
present
3
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